Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN90432-AGACNP-BC | WV |
NPI | 1023588449 |
---|---|
Provider Name | Bessie J Raines |
First Address | Martinsburg, WV 25401-8801 |
Second Address | Winchester, VA 22601-6448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2018 |
Last Update Date | 21/04/2021 |