=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427942069
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL MULLEN RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2025
-----------------------------------------------------
Last Update Date | 06/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 E 3RD ST RM 302
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-4026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-532-6906
-----------------------------------------------------
Fax | 308-532-6964
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 615 N LINCOLN AVE
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-7019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-530-6813
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Registered Nurse
-----------------------------------------------------
License Number | 85147
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------