Provider Demographics
NPI:1124142039
Name:RAINONE, STEPHANIE (RN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:RAINONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2108
Mailing Address - Country:US
Mailing Address - Phone:401-949-1489
Mailing Address - Fax:
Practice Address - Street 1:125 BAY VIEW AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-4955
Practice Address - Country:US
Practice Address - Phone:401-438-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN39472163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISR61501Medicaid