Healthcare Provider Details

I. General information

NPI: 1649183468
Provider Name (Legal Business Name): RACHEL E ETIENNE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 OLD MAIN ST
HARTFORD KY
42347-1619
US

IV. Provider business mailing address

PO BOX 148
HARTFORD KY
42347-0148
US

V. Phone/Fax

Practice location:
  • Phone: 270-298-7411
  • Fax: 270-298-3824
Mailing address:
  • Phone: 270-504-1910
  • Fax: 270-298-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008564
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: