Healthcare Provider Details

I. General information

NPI: 1346741360
Provider Name (Legal Business Name): RACHEL STARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4799 STATE ROUTE 37 E
DELAWARE OH
43015-7614
US

IV. Provider business mailing address

4799 STATE ROUTE 37 EAST
DELAWARE OH
43015
US

V. Phone/Fax

Practice location:
  • Phone: 740-362-2041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: