Healthcare Provider Details

I. General information

NPI: 1275924730
Provider Name (Legal Business Name): RACHEL KENDALL APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CENTRAL ST UNIT 1
RANDOLPH VT
05060-1039
US

IV. Provider business mailing address

10 CAMELIA AVE
CAMBRIDGE MA
02139-1008
US

V. Phone/Fax

Practice location:
  • Phone: 802-431-6030
  • Fax: 802-735-1664
Mailing address:
  • Phone: 617-665-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN2310970
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number051160-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number101.0107798
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: