Healthcare Provider Details

I. General information

NPI: 1619801099
Provider Name (Legal Business Name): RACHEL AMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MONTROSE WEST AVE
COPLEY OH
44321-3121
US

IV. Provider business mailing address

1630 34TH ST NE
CANTON OH
44714-1564
US

V. Phone/Fax

Practice location:
  • Phone: 330-993-4649
  • Fax:
Mailing address:
  • Phone: 234-802-5768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.556858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: