Provider Demographics
NPI:1962143263
Name:MITCHELL, RACHEL (CRNP, BSN, RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CRNP, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 KELLER PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-1417
Mailing Address - Country:US
Mailing Address - Phone:256-381-6963
Mailing Address - Fax:
Practice Address - Street 1:234 KELLER PARK BLVD
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1417
Practice Address - Country:US
Practice Address - Phone:256-381-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-159419163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse