Provider Demographics
NPI:1124687462
Name:MILLER, RACHAEL LEA (RN, NP, APRN)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LEA
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, NP, APRN
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:LEA
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1707 EYE ST # 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5208
Mailing Address - Country:US
Mailing Address - Phone:613-103-6886
Mailing Address - Fax:
Practice Address - Street 1:1551 E SHAW AVE STE 139
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8025
Practice Address - Country:US
Practice Address - Phone:559-320-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023582363LP0808X
CA95180773163W00000X
KS14-127624-062163W00000X
MO2013036996163W00000X
MO2019017374363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse