Healthcare Provider Details

I. General information

NPI: 1619686250
Provider Name (Legal Business Name): RACHEL MARIE EVANS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BRIDLEPATH CT
FREDERICKSBURG VA
22408-8813
US

IV. Provider business mailing address

8006 SOURWOOD CT
SPOTSYLVANIA VA
22551-2761
US

V. Phone/Fax

Practice location:
  • Phone: 540-847-1936
  • Fax:
Mailing address:
  • Phone: 804-591-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246R00000X
TaxonomyPathology Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: