Healthcare Provider Details

I. General information

NPI: 1770312670
Provider Name (Legal Business Name): RACHEL RICHARD LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 QUEENS ROW
CROWLEY LA
70526-6905
US

IV. Provider business mailing address

618 S AVENUE H
CROWLEY LA
70526-5767
US

V. Phone/Fax

Practice location:
  • Phone: 337-458-0291
  • Fax:
Mailing address:
  • Phone: 337-458-0291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number20120114
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: