Healthcare Provider Details

I. General information

NPI: 1194539908
Provider Name (Legal Business Name): RACHEL CHRISTIAN DEAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 BRYAN ST W
DOUGLAS GA
31533-2330
US

IV. Provider business mailing address

906 BRYAN ST W
DOUGLAS GA
31533-2330
US

V. Phone/Fax

Practice location:
  • Phone: 912-309-2319
  • Fax:
Mailing address:
  • Phone: 912-383-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License NumberRN286637
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN286637
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: