Healthcare Provider Details

I. General information

NPI: 1437933405
Provider Name (Legal Business Name): RACHELLE M. SCHULTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 E LAWRENCE RD
LAWRENCEVILLE PA
16929-8801
US

IV. Provider business mailing address

40 W WELLSBORO ST
MANSFIELD PA
16933-1411
US

V. Phone/Fax

Practice location:
  • Phone: 570-827-0125
  • Fax:
Mailing address:
  • Phone: 570-662-1945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN696316
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP028352
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: