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General NPI Number Information
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NPI Number | 1427874577
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Entity Type | Individual
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Provider Name | RACHEL V WHITLEY CSFA, CST
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1101 OCILLA RD
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City | DOUGLAS
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State | GA
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Zip | 31533-2262
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Country | US
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Telephone | 912-384-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 499 WHITE PINE HWY
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City | NICHOLLS
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State | GA
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Zip | 31554-3703
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Country | US
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Telephone |
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 172433
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 172433
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 172433
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License Number State | GA
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