Provider Demographics
NPI:1235950601
Name:RAINEY, SAMANTHA RAYE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:RAYE
Last Name:RAINEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2573 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-8071
Mailing Address - Country:US
Mailing Address - Phone:469-247-2334
Mailing Address - Fax:
Practice Address - Street 1:5101 WELLINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-6012
Practice Address - Country:US
Practice Address - Phone:903-455-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1178371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily