Healthcare Provider Details

I. General information

NPI: 1780670232
Provider Name (Legal Business Name): RACHELLE MARIE MUELLER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 04/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3268 VIA ENSENADA
SAN LUIS OBISPO CA
93401-6970
US

IV. Provider business mailing address

3268 VIA ENSENADA
SAN LUIS OBISPO CA
93401-6970
US

V. Phone/Fax

Practice location:
  • Phone: 805-544-3267
  • Fax: 805-544-3267
Mailing address:
  • Phone: 805-544-3267
  • Fax: 805-544-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN301355
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN301355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: