Provider Demographics
NPI:1588899306
Name:WRUBLE, RACHAEL ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:ANNE
Last Name:WRUBLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:RACHAEL
Other - Middle Name:ANNE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-1330
Mailing Address - Country:US
Mailing Address - Phone:704-860-9944
Mailing Address - Fax:704-825-5318
Practice Address - Street 1:2 KENWOOD ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3135
Practice Address - Country:US
Practice Address - Phone:704-825-5322
Practice Address - Fax:704-825-5318
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2165152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1588899306Other1588899306