Basic Information
| Provider Information | |||||||||
| NPI: | 1720403827 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAINES | ||||||||
| FirstName: | MICHAELA | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 N CEDAR CREST BLVD STE 411 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181042323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109691914 | ||||||||
| FaxNumber: | 6109693951 | ||||||||
| Practice Location | |||||||||
| Address1: | 2545 SCHOENERSVILLE RD | ||||||||
| Address2: | 5TH FLOOR LVH-M SOUTH | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848846503 | ||||||||
| FaxNumber: | 4848846504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2014 | ||||||||
| LastUpdateDate: | 05/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | SP013712 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.