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General NPI Number Information
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NPI Number | 1265012090
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Entity Type | Individual
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Provider Name | RACHAEL M DENT AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 1720 2ND AVE S # NB1002
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City | BIRMINGHAM
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State | AL
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Zip | 35294-1210
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Country | US
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Telephone | 205-975-7529
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 IVY MILL DR
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City | BUFORD
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State | GA
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Zip | 30519-6702
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Country | US
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Telephone | 404-906-4284
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN209337
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN209337
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License Number State | GA
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