Individual
DESIREE RAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
818 SUNSET DR STE 102, JOHNSON CITY, TN 37604-8310
(423) 794-3142
Mailing address
818 SUNSET DR STE 102, JOHNSON CITY, TN 37604-8310
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000019740
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q015505
—
TN
Enumeration date
07/13/2015
Last updated
07/22/2016
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