Healthcare Provider Details

I. General information

NPI: 1821410903
Provider Name (Legal Business Name): RACHIEL MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3338 BARFIELD DR
CHARLOTTE NC
28217-1108
US

IV. Provider business mailing address

3338 BARFIELD DR
CHARLOTTE NC
28217-1108
US

V. Phone/Fax

Practice location:
  • Phone: 704-492-6289
  • Fax:
Mailing address:
  • Phone: 704-492-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number195189
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: