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General NPI Number Information
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NPI Number | 1205411535
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Entity Type | Individual
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Provider Name | RACHEL LOUISE CLOSSER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 13203 BIG RIVER DR
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1983
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Country | US
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Telephone | 573-639-9219
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Fax |
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Provider Business Mailing Address
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Address Line | 13203 BIG RIVER DR
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1983
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Country | US
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Telephone | 573-639-9219
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2012016633
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041403271
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021009748
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License Number State | MO
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