Provider Demographics
NPI:1841266442
Name:RAINEY, JESSICA KEITH (CRNP)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:KEITH
Last Name:RAINEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:206 STONECREST CT
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3967
Mailing Address - Country:US
Mailing Address - Phone:404-321-4922
Mailing Address - Fax:
Practice Address - Street 1:774 ATHENS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:GA
Practice Address - Zip Code:30648-1908
Practice Address - Country:US
Practice Address - Phone:706-743-8183
Practice Address - Fax:706-769-4402
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN068772363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care