Jillalison Lee Rainey, RN, BSN

Individual provider Active NPI Registered Nurse · Garden Ridge, TX

NPI 1124314448 · NPPES record last updated Jun 24, 2011

Key facts

NPI
1124314448
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
L1-0038069 (DE)
Practice address
18945 FM 2252 Ste 115
Garden Ridge, TX 78266-2797
Phone
(866) 595-6379
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
L1-0038069DEMDRegistered Nurse
26NR14890400NJMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0038069 DE Yes
Registered Nurse 163W00000X 26NR14890400 NJ

Addresses

Primary practice location

18945 FM 2252 Ste 115
Garden Ridge, TX 78266-2797

Mailing address

320 Pomelo Drive
Apartment 218
Vista, CA 92081-6477
Phone (609) 805-1459

Other providers in Garden Ridge, TX

All providers in Garden Ridge, TX · Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.