Healthcare Provider Details

I. General information

NPI: 1477367464
Provider Name (Legal Business Name): RACHEL NAUMANN MS, CNS, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N CHURCH ST PMB 55508
WILMINGTON DE
19802-4447
US

IV. Provider business mailing address

60 GRASSY HILL RD
ROXBURY CT
06783-1812
US

V. Phone/Fax

Practice location:
  • Phone: 773-906-4773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number002788
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: