Individual
MRS. MARTHA ANN RAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
100 E WOOD ST, SUITE 202, SPARTANBURG, SC 29303-3004
(864) 560-7070
(864) 560-7073
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
68713
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000519
—
NC
05
—
NP1370
—
SC
01
—
P00721826
RR MEDICARE
SC
Enumeration date
02/16/2009
Last updated
12/08/2020
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