Healthcare Provider Details

I. General information

NPI: 1639047897
Provider Name (Legal Business Name): RACHEL MARIE NOWICKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 QUARTZ ST
ONTONAGON MI
49953-1115
US

IV. Provider business mailing address

33304 HALFWAY RIVER RD 515 QUARTZ STREET
ONTONAGON MI
49953-9102
US

V. Phone/Fax

Practice location:
  • Phone: 906-884-4804
  • Fax: 906-884-4856
Mailing address:
  • Phone: 906-299-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: