Provider Demographics
NPI:1316058910
Name:ETNIER, RACHAEL D (DO)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:D
Last Name:ETNIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2019
Mailing Address - Country:US
Mailing Address - Phone:844-474-4321
Mailing Address - Fax:
Practice Address - Street 1:840 W US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:IA
Practice Address - Zip Code:50438-1023
Practice Address - Country:US
Practice Address - Phone:641-925-1500
Practice Address - Fax:641-925-1507
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0443085Medicaid
IAI38934Medicare UPIN