Healthcare Provider Details

I. General information

NPI: 1922916915
Provider Name (Legal Business Name): RACHAEL ANN FENSTERMAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2756 FIVE POINTS HARTFORD RD
FOWLER OH
44418-9755
US

IV. Provider business mailing address

2756 FIVE POINTS HARTFORD RD
FOWLER OH
44418-9755
US

V. Phone/Fax

Practice location:
  • Phone: 330-651-4853
  • Fax:
Mailing address:
  • Phone: 330-651-4853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAG07260060
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: