Basic Information
| Provider Information | |||||||||
| NPI: | 1841531282 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAINS | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | LUELLA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10550 MARTY ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662122557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133414000 | ||||||||
| FaxNumber: | 9133832868 | ||||||||
| Practice Location | |||||||||
| Address1: | 10550 MARTY ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662122557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133414000 | ||||||||
| FaxNumber: | 9133832868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2013 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 14-143751-091 | KS | N | Nursing Service Providers | Registered Nurse | 163W00000X | 2016002931 | MO | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 2020013780 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 53-79468-091 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.