Provider Demographics
NPI:1699094565
Name:WHITFIELD, RACHEL L (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:L
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 STONEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-1187
Mailing Address - Country:US
Mailing Address - Phone:770-389-0491
Mailing Address - Fax:770-389-0491
Practice Address - Street 1:3528 STONEFIELD CT
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1187
Practice Address - Country:US
Practice Address - Phone:770-389-0491
Practice Address - Fax:770-389-0491
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN128196291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory