Healthcare Provider Details

I. General information

NPI: 1689508160
Provider Name (Legal Business Name): RACHEL CHURCHILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 E OLYMPIA AVE
MANILA AR
72442-9182
US

IV. Provider business mailing address

419 E OLYMPIA AVE
MANILA AR
72442-9182
US

V. Phone/Fax

Practice location:
  • Phone: 870-561-3145
  • Fax: 870-561-8119
Mailing address:
  • Phone: 870-561-3145
  • Fax: 870-561-8119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR77382
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: