Provider Demographics
NPI:1528947827
Name:ROSS, RACHAEL MARIE (CPHT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MARIE
Last Name:ROSS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:CRESWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2308 RAINBOW
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65793-3607
Mailing Address - Country:US
Mailing Address - Phone:816-401-1212
Mailing Address - Fax:
Practice Address - Street 1:110 BEAR DR STE 4
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65793-7103
Practice Address - Country:US
Practice Address - Phone:417-469-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023005313183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician