1316606890 NPI number — MRS. PEARL RAINEY CD(CERTIFIED DOULA)

Table of content: MRS. PEARL RAINEY CD(CERTIFIED DOULA) (NPI 1316606890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316606890 NPI number — MRS. PEARL RAINEY CD(CERTIFIED DOULA)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAINEY
Provider First Name:
PEARL
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CD(CERTIFIED DOULA)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAINEY
Provider Other First Name:
PEARL
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PEARL RAINEY NBDA-CD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1316606890
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
744 EAYRESTOWN RD APT 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUMBERTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08048-3124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-592-0873
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
744 EAYRESTOWN RD APT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08048-3124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-592-0873
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374J00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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