Provider Demographics
NPI:1740157536
Name:DILLON, RACHEL (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DILLON
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 1:3173 N 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-3614
Mailing Address - Country:US
Mailing Address - Phone:414-553-6688
Mailing Address - Fax:901-791-4390
Practice Address - Street 1:3173 N 41ST ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3614
Practice Address - Country:US
Practice Address - Phone:414-553-6688
Practice Address - Fax:901-791-4390
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1115955163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1115955OtherRN