Individual
SUSAN RAINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(765) 289-2353
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71000202
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200279350
—
IN
Enumeration date
08/12/2006
Last updated
04/25/2011
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