# RAINBOW PEDIATRIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255474300
- **Authorized official:** GINA M DIEUDONNE MD (OWNER)
- **Authorized official phone:** (731) 784-7833

## Contact information

- **Practice address:** 3535 CHERE CAROL RD, HUMBOLDT, TN 38343-3634
- **Practice address phone:** (731) 784-7833
- **Practice address fax:** (731) 337-7000
- **Mailing address:** 1636 E MAIN STREET, HUMBOLDT, TN 38343
- **Mailing address phone:** (731) 784-7833
- **Mailing address fax:** (731) 784-7856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 41750 | TN | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 07/21/2026