Healthcare Provider Details

I. General information

NPI: 1720253420
Provider Name (Legal Business Name): RACHEL TESTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL DEVENEY APRN

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST PROCTOR 318
BELMONT MA
02478-1064
US

IV. Provider business mailing address

115 MILL ST PROCTOR 318
BELMONT MA
02478-1064
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-2215
  • Fax:
Mailing address:
  • Phone: 617-855-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number256969
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: