Healthcare Provider Details

I. General information

NPI: 1790452555
Provider Name (Legal Business Name): RACHEL KATHARINE CIVALE DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

523 EDISTO CT
CHAPEL HILL NC
27514-1673
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-1000
  • Fax:
Mailing address:
  • Phone: 631-905-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number151523
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number306219
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7520
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: