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General NPI Number Information
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NPI Number | 1114894946
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Entity Type | Individual
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Provider Name | RACHYL CHEYENNE KELLEY-DEBORD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 96 RED HILL CHURCH RD
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City | ATTALLA
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State | AL
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Zip | 35954-5673
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Country | US
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Telephone | 256-490-0614
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Fax |
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Provider Business Mailing Address
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Address Line | 96 RED HILL CHURCH RD
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City | ATTALLA
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State | AL
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Zip | 35954-5673
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Country | US
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Telephone |
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Fax | 256-399-5056
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-182349
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License Number State | AL
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