Healthcare Provider Details

I. General information

NPI: 1114838372
Provider Name (Legal Business Name): RACHEL SMITH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

3340 KEICHTEE DR
RICHMOND VA
23225-1610
US

V. Phone/Fax

Practice location:
  • Phone: 804-628-4368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0601X
TaxonomyOtorhinolaryngology & Head-Neck Registered Nurse
License Number0001213521
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: