Healthcare Provider Details

I. General information

NPI: 1548610876
Provider Name (Legal Business Name): RACHEL ANN CHOATE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E SUNSHINE ST
SPRINGFIELD MO
65804-1214
US

IV. Provider business mailing address

PO BOX 10939
SPRINGFIELD MO
65808-0939
US

V. Phone/Fax

Practice location:
  • Phone: 417-880-0575
  • Fax: 417-881-3614
Mailing address:
  • Phone: 417-880-0575
  • Fax: 417-881-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06161376
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: