Raines, Stacey Delane
Raines, Stacey Delane is an individual health care provider with primary practice located at 2704 Alexander Dr Suite E, Jonesboro AR 72401-7070. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Raines, Stacey Delane can be contacted via phone (870) 336-3937.Contact Information
Primary practice address
2704 Alexander Dr Suite E
Jonesboro AR 72401-7070
Phone: (870) 336-3937
Fax: (870) 336-3934
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2454 | Arkansas |
Profile Details
| NPI number | 1790779676 |
|---|---|
| LBN Legal business name | Raines, Stacey Delane |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Feb 5th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790779676 | NPPES |
| Arkansas | MEDICAID | 130329722 | |
| Arkansas | Other | 49100 | |
| Arkansas | Other | 5069225 | |
| Arkansas | Other | 696627 | |
| Arkansas | Other | 25158 |
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