Healthcare Provider Details

I. General information

NPI: 1467053827
Provider Name (Legal Business Name): RACHEL ORTEGA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 N SHOOP AVE
WAUSEON OH
43567-1814
US

IV. Provider business mailing address

225 N IRWIN RD
HOLLAND OH
43528-9745
US

V. Phone/Fax

Practice location:
  • Phone: 419-285-9002
  • Fax:
Mailing address:
  • Phone: 419-255-7883
  • Fax: 419-720-7895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0027729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: