Healthcare Provider Details

I. General information

NPI: 1417471822
Provider Name (Legal Business Name): RACHEL MARIE COVERT RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 06/26/2021
Certification Date: 06/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5854 STATE ROUTE 96 APT 208A
ROMULUS NY
14541-9579
US

IV. Provider business mailing address

5854 STATE ROUTE 96 APT 208A
ROMULUS NY
14541-9579
US

V. Phone/Fax

Practice location:
  • Phone: 315-525-0302
  • Fax:
Mailing address:
  • Phone: 315-525-0302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number660980
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: