Healthcare Provider Details

I. General information

NPI: 1871280891
Provider Name (Legal Business Name): RACHEL ALBA FROST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 HARPER ST
AUGUSTA GA
30912-0012
US

IV. Provider business mailing address

721 GENTLEWIND LN
MARTINEZ GA
30907-3160
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-5437
  • Fax:
Mailing address:
  • Phone: 321-961-7817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN715589
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-NP715589
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: