=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174199319
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL NAVARRETTE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2021
-----------------------------------------------------
Last Update Date | 04/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9417 S BROADWAY
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63125-2009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-833-4030
-----------------------------------------------------
Fax | 314-833-4031
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5501 DELMAR BLVD STE B560
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63112-3084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-833-4030
-----------------------------------------------------
Fax | 314-833-4031
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F07202203
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------