Provider Demographics
NPI:1528778305
Name:BREDY, RACHELLE (LPN)
Entity type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:
Last Name:BREDY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:ALEXANDRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3842
Mailing Address - Country:US
Mailing Address - Phone:781-856-4690
Mailing Address - Fax:
Practice Address - Street 1:137 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2009
Practice Address - Country:US
Practice Address - Phone:781-762-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN68720164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse