Provider Demographics
NPI:1962756668
Name:RAINS, AMY R (CRNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:RAINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5679
Mailing Address - Country:US
Mailing Address - Phone:620-272-2261
Mailing Address - Fax:620-276-3645
Practice Address - Street 1:401 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5679
Practice Address - Country:US
Practice Address - Phone:620-272-2261
Practice Address - Fax:620-276-3645
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS091072367500000X
CA95002042367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered