Healthcare Provider Details
I. General information
NPI: 1669561106
Provider Name (Legal Business Name): RACHEL K ANDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13808 W MAPLE RD STE 100 CHILDREN'S HOSPITAL - URGENT CARE
OMAHA NE
68164-6231
US
IV. Provider business mailing address
8200 DODGE ST CHILDREN'S HOSPITAL
OMAHA NE
68114-4113
US
V. Phone/Fax
- Phone: 402-955-3600
- Fax: 402-955-7055
- Phone: 402-955-5400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 22709 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: