Healthcare Provider Details

I. General information

NPI: 1205727153
Provider Name (Legal Business Name): RACHEL ANN EARLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 34TH AVE E
ALEXANDRIA MN
56308-2599
US

IV. Provider business mailing address

702 34TH AVE E
ALEXANDRIA MN
56308-2599
US

V. Phone/Fax

Practice location:
  • Phone: 320-762-2400
  • Fax:
Mailing address:
  • Phone: 320-762-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13077
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2016050
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: