Healthcare Provider Details

I. General information

NPI: 1164075131
Provider Name (Legal Business Name): RACHEL CHRISTINA BUSBY-DREWEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 MICCOSUKEE RD
TALLAHASSEE FL
32308-5359
US

IV. Provider business mailing address

2505 BLUEBELL PL
TALLAHASSEE FL
32308-6231
US

V. Phone/Fax

Practice location:
  • Phone: 850-942-2299
  • Fax:
Mailing address:
  • Phone: 850-509-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11003071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: