=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306625173
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KERRI RACHELLE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2023
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 CENTRE CT
-----------------------------------------------------
City | PALMYRA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22963-2329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-906-9196
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 CENTRE CT
-----------------------------------------------------
City | PALMYRA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22963-2329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-374-1848
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KERRI RACHELLE
-----------------------------------------------------
Credential | RDN, CSSD
-----------------------------------------------------
Telephone | 434-374-1848
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 133NN1002X
-----------------------------------------------------
Taxonomy Name | Nutrition Education Nutritionist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------