Healthcare Provider Details

I. General information

NPI: 1063345874
Provider Name (Legal Business Name): RACHEL HAKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 HIGH AVE
NILES OH
44446-3336
US

IV. Provider business mailing address

524 HIGH AVENUE
NILES OH
44446
US

V. Phone/Fax

Practice location:
  • Phone: 330-503-0455
  • Fax:
Mailing address:
  • Phone: 330-503-0455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number555143
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: