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Individual

KENNETH B RAINEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.P.R.N.

Contact information

Practice address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 422-0213
(731) 256-7664
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 425-5752
(731) 425-5783

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
30941
TN

Other

Enumeration date
03/15/2022
Last updated
10/25/2023
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