Healthcare Provider Details

I. General information

NPI: 1215562533
Provider Name (Legal Business Name): RACHEL LYNN BOND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 RED VENTURES DR STE 130
FORT MILL SC
29707-2516
US

IV. Provider business mailing address

PO BOX 470408
CHARLOTTE NC
28247-0408
US

V. Phone/Fax

Practice location:
  • Phone: 704-375-0100
  • Fax: 704-887-6450
Mailing address:
  • Phone: 704-375-0100
  • Fax: 704-887-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number27351
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number0000180451
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number25920
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: