Healthcare Provider Details

I. General information

NPI: 1245326594
Provider Name (Legal Business Name): RACHEL SPIVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 MERCHANT DR
RICHMOND KY
40475-8167
US

IV. Provider business mailing address

65 OAK VALLEY CT
IRVINE KY
40336-9428
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-7977
  • Fax: 859-626-5103
Mailing address:
  • Phone: 606-726-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: