Healthcare Provider Details

I. General information

NPI: 1023531506
Provider Name (Legal Business Name): RACHEL CARSON DOERR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 RIGGINS RD
TALLAHASSEE FL
32308-5317
US

IV. Provider business mailing address

PO BOX 13834
TALLAHASSEE FL
32317-3834
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-4134
  • Fax: 850-942-4112
Mailing address:
  • Phone: 850-877-4134
  • Fax: 850-942-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11003563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: