Healthcare Provider Details

I. General information

NPI: 1609315092
Provider Name (Legal Business Name): RACHEL KIRKMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL COURTNEY DO

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BELLEMEADE AVE STE 200E
EVANSVILLE IN
47714-0114
US

IV. Provider business mailing address

3801 BELLEMEADE AVE STE 200E
EVANSVILLE IN
47714-0114
US

V. Phone/Fax

Practice location:
  • Phone: 812-485-7240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02005963A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: