Provider Demographics
NPI:1841823713
Name:DAVIS, RACHEL NICOLE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 FREEZE RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2135
Mailing Address - Country:US
Mailing Address - Phone:434-770-0564
Mailing Address - Fax:
Practice Address - Street 1:529 FREEZE RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2135
Practice Address - Country:US
Practice Address - Phone:434-770-0564
Practice Address - Fax:877-316-3453
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle