Provider Demographics
NPI:1386353720
Name:MOWER, RACHAEL ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ANN
Last Name:MOWER
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 1:300 W SEDGEWICK DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-8370
Mailing Address - Country:US
Mailing Address - Phone:509-952-6923
Mailing Address - Fax:
Practice Address - Street 1:300 W SEDGEWICK DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-8370
Practice Address - Country:US
Practice Address - Phone:509-952-6923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID39765163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse