Provider Demographics
NPI:1558185553
Name:HOEFER, RACHEL (BSN, RN, PMH-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HOEFER
Suffix:
Gender:F
Credentials:BSN, RN, PMH-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 S 71ST ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53219-1955
Mailing Address - Country:US
Mailing Address - Phone:262-225-0153
Mailing Address - Fax:
Practice Address - Street 1:725 AMERICAN AVE STE 501
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5031
Practice Address - Country:US
Practice Address - Phone:262-225-0153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI236347163W00000X
WI2022152249163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health