Most Relevant Information
Provider Data
| NPI Number: | 1003580200 |
| Provider Name: | CAMILLE RAINEY CNA |
| Entity Type: | Individual |
| Taxonomy Code: | 311500000X |
| Specialty: | Alzheimer Center (Dementia Center) |
| License Number: | 0008554435 |
Most Important Dates
| Enumeration Date: | 08/03/2021 |
| Last Updated: | 08/03/2021 |
Provider Practice Location
5717 TWAIN DR
ELLENWOOD
GA
302943937
Practice Location Phone/Fax
| Phone: | 6785582586 |
| Fax: |
Provider Mailing Location
5717 TWAIN DR
ELLENWOOD
GA
302943937
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |