=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265520308
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL L WATE N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2006
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1263 HOSPITAL DR NW STE 105
-----------------------------------------------------
City | CORYDON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47112-2173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-734-3800
-----------------------------------------------------
Fax | 812-738-7833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 38
-----------------------------------------------------
City | CORYDON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47112-0038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-738-4251
-----------------------------------------------------
Fax | 812-738-4251
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 71001897A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------