MEDICARE: RACHEL REICH MSN, NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A006007	AR

General Provider Information

NPI Number	:	1790344109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL REICH MSN, NP-C

Provider Business Mailing Address
First Line	:	614 E EMMA AVE STE 300
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72764-4469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 N MOUNT OLIVE ST STE 1
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-9509
Country	:	US
Telephone Number	:	479-524-8175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	06/10/2019

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