Healthcare Provider Details

I. General information

NPI: 1366840308
Provider Name (Legal Business Name): RACHEL PHILIPPS CHENOWETH APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 STARR AVE
EAU CLAIRE WI
54703-1821
US

IV. Provider business mailing address

1000 N OAK AVE
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 715-858-4300
  • Fax:
Mailing address:
  • Phone: 715-397-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberALPP-201563
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13058-33
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13058-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: