Provider Demographics
NPI:1306591557
Name:CORL, RACHEL ANN (APRN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:CORL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 MERCIER ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2130
Mailing Address - Country:US
Mailing Address - Phone:417-274-1090
Mailing Address - Fax:
Practice Address - Street 1:8404 MERCIER ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2130
Practice Address - Country:US
Practice Address - Phone:417-274-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-139501-102163W00000X
MO2009017349163W00000X
KS53-80930-102363LF0000X
MO2022003806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse