Healthcare Provider Details

I. General information

NPI: 1174938047
Provider Name (Legal Business Name): RACHEL DYCHES DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 06/20/2020
Certification Date: 06/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-9122
US

IV. Provider business mailing address

4245 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-9122
US

V. Phone/Fax

Practice location:
  • Phone: 678-990-3962
  • Fax: 678-840-3777
Mailing address:
  • Phone: 803-308-1983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number104039
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18900
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: