Individual
DR. STACEY DELANE RAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2704 ALEXANDER DR, SUITE E, JONESBORO, AR 72401-7070
(870) 336-3937
(870) 336-3934
Mailing address
PO BOX 17287, JONESBORO, AR 72403-6723
(870) 336-3937
(870) 336-3934
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2454
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130329722
—
AR
01
—
25158
SPECTERA
AR
01
—
49100
BLUE CROSS BLUE SHIELD
AR
01
—
5069225
AETNA
AR
01
—
696627
OPTICHOICE
AR
Enumeration date
09/07/2005
Last updated
02/05/2008
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