Individual
MRS. CRYSTAL BRANAN RAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3508
Mailing address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3508
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
9438366
FL
363LN0005X
Critical Care Neonatal Nurse Practitioner
9438366
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003184890A
—
GA
05
—
019365400
—
FL
Enumeration date
11/07/2016
Last updated
01/14/2022
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