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General NPI Number Information
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NPI Number | 1295416675
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Entity Type | Individual
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Provider Name | RACHEL FIRESTONE RN, CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 1711 S STEPHENSON AVE
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-3639
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Country | US
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Telephone | 906-774-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 2903 POPE DR
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City | CHATTANOOGA
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State | TN
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Zip | 37404-6342
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Country | US
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Telephone | 918-982-2585
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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 | 114366
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License Number State | OK
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