Individual
MS. MARY LOUISE RAINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
1903 SUNRISE BLVD, FORT PIERCE, FL 34950-8101
(772) 475-8560
(772) 801-5293
Mailing address
1903 SUNRISE BLVD, FORT PIERCE, FL 34950-8101
(772) 475-8560
(772) 801-5293
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006593100
—
FL
Enumeration date
09/21/2012
Last updated
08/06/2013
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