Individual
KELLY ANN RAINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6620
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000930
CT
363AS0400X
Surgical Physician Assistant
Primary
000930
CT
Other
Enumeration date
05/02/2006
Last updated
03/08/2012
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