Provider Demographics
NPI:1902799844
Name:BERRY, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BERRY
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 1:14880 STATE ROUTE 554
Mailing Address - Street 2:
Mailing Address - City:BIDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:45614-9046
Mailing Address - Country:US
Mailing Address - Phone:740-339-7113
Mailing Address - Fax:
Practice Address - Street 1:14880 STATE ROUTE 554
Practice Address - Street 2:
Practice Address - City:BIDWELL
Practice Address - State:OH
Practice Address - Zip Code:45614-9046
Practice Address - Country:US
Practice Address - Phone:740-339-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant