Provider Demographics
NPI:1104132067
Name:GAUDET, RACHEL KATHERINE (RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KATHERINE
Last Name:GAUDET
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1905
Mailing Address - Country:US
Mailing Address - Phone:508-954-5334
Mailing Address - Fax:508-252-3430
Practice Address - Street 1:112 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-3257
Practice Address - Country:US
Practice Address - Phone:401-453-1111
Practice Address - Fax:401-453-4850
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN257732163W00000X
RIRN40537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse