Healthcare Provider Details

I. General information

NPI: 1386733897
Provider Name (Legal Business Name): RACHELLE RICHARDSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3134 NORTHSIDE DR BLD B
KEY WEST FL
33040-8004
US

IV. Provider business mailing address

PO BOX 6193
KEY WEST FL
33041-6193
US

V. Phone/Fax

Practice location:
  • Phone: 305-292-6885
  • Fax: 305-293-1561
Mailing address:
  • Phone: 305-809-5680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number308584
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-09100
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9304753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: