MEDICARE: JEANNE RACHEL APPELL RN, NP, CDE

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	163WD0400X	Diabetes Educator Registered Nurse	505268	CA

General Provider Information

NPI Number	:	1962901199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE RACHEL APPELL RN, NP, CDE

Provider Business Mailing Address
First Line	:	12025 PROSPECT HILL DR
Second Line	:
City	:	GOLD RIVER
State	:	CA
Zip	:	95670-7532
Country	:	US
Telephone Number	:	916-337-0728
Fax Number	:

Provider Business Practice Location Address
First Line	:	3581 PALMER DR STE 201
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-8237
Country	:	US
Telephone Number	:	530-672-7021
Fax Number	:	530-748-0338

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

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	02/02/2018

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