Individual
JEANNIE LEANN BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
Mailing address
180 GALA ST, RAINSVILLE, AL 35986-4477
(256) 996-9371
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-094402
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-094402
NP LICENSE
AL
01
—
9521
RX
AL
Enumeration date
03/19/2021
Last updated
11/05/2021
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