Provider Demographics
NPI:1528839990
Name:LACLAIR, RACHEL (LAC, RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LACLAIR
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 OWEN RD
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3527
Mailing Address - Country:US
Mailing Address - Phone:608-345-8541
Mailing Address - Fax:608-710-0278
Practice Address - Street 1:136 OWEN RD
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3527
Practice Address - Country:US
Practice Address - Phone:608-345-8541
Practice Address - Fax:608-710-0278
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI172497-30163W00000X
WI1034-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse