Provider Demographics
NPI:1588409874
Name:RAYNER, NEDRA STARLENE
Entity type:Individual
Prefix:
First Name:NEDRA
Middle Name:STARLENE
Last Name:RAYNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 WOODMOOR ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-2483
Mailing Address - Country:US
Mailing Address - Phone:330-685-8980
Mailing Address - Fax:
Practice Address - Street 1:305 WOODMOOR ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-2483
Practice Address - Country:US
Practice Address - Phone:330-685-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH325075163WH0200X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health