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General NPI Number Information
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NPI Number | 1265003081
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Entity Type | Individual
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Provider Name | RACHEL BARDOS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 7101 GUILFORD DR STE 100
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City | FREDERICK
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State | MD
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Zip | 21704-5198
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Country | US
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Telephone | 240-464-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 W DUNLAP AVE STE 124
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City | PHOENIX
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State | AZ
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Zip | 85021-2813
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Country | US
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Telephone | 801-369-8989
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Fax | 801-704-9741
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | ACO04691
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202105379NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 258717
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License Number State | AZ
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