Individual
MRS. KIM MARIE RAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNP, AGACNP
Contact information
Practice address
204 W 26TH ST, ERIE, PA 16508-1806
(814) 864-4755
Mailing address
6010 WILDWOOD DRIVE, FAIRVIEW, PA 16415
(814) 460-4284
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP019370
PA
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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