Provider Demographics
NPI:1962732511
Name:RIEL, RACHEL ANNE (LPN)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ANNE
Last Name:RIEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19999 LOWER FREDERICKTOWN AMITY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-9387
Mailing Address - Country:US
Mailing Address - Phone:740-504-3782
Mailing Address - Fax:
Practice Address - Street 1:19999 LOWER FREDERICKTOWN AMITY RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-9387
Practice Address - Country:US
Practice Address - Phone:740-504-3782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN120632164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse