Healthcare Provider Details

I. General information

NPI: 1255913208
Provider Name (Legal Business Name): RACHEL ANN DAVID MPH, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ANN PANKAU MPH, RDN, LD

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 S GEAR AVE
WEST BURLINGTON IA
52655-1691
US

IV. Provider business mailing address

1225 S GEAR AVE STE 152
WEST BURLINGTON IA
52655-1686
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-3907
  • Fax:
Mailing address:
  • Phone: 816-387-1077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2016030006
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2016030006
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number125602
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: