Healthcare Provider Details

I. General information

NPI: 1659128155
Provider Name (Legal Business Name): RACHEL WOODS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 E 9TH ST
ROCHESTER IN
46975-8931
US

IV. Provider business mailing address

1400 E 9TH ST
ROCHESTER IN
46975-8937
US

V. Phone/Fax

Practice location:
  • Phone: 574-223-9393
  • Fax: 574-406-9116
Mailing address:
  • Phone: 574-223-9393
  • Fax: 574-406-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28164275C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: