Healthcare Provider Details

I. General information

NPI: 1083133300
Provider Name (Legal Business Name): RACHEL WARBURTON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 MACON RD STE D
COLUMBUS GA
31907-2582
US

IV. Provider business mailing address

2500 18TH AVE
COLUMBUS GA
31901-1340
US

V. Phone/Fax

Practice location:
  • Phone: 706-888-3933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN198436
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: