Individual
HIAWATHA VENESSA RAINEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3424 KENSINGTON DR S, AUGUSTA, GA 30906-6002
(706) 306-0091
Mailing address
3424 KENSINGTON DR S, AUGUSTA, GA 30906-6002
(706) 306-0091
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0000012334
GA
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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