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General NPI Number Information
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NPI Number | 1669159174
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Entity Type | Organization
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Legal Business Name | TRUCARE TELEMENTAL HEALTH PLLC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 732 FLAGLER ROAD.
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City | EGLIN AFB
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State | FL
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Zip | 32542
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Country | US
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Telephone | 850-821-2936
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Fax |
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Provider Business Mailing Address
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Address Line | 4516 E HIGHWAY 20 # 3075
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City | NICEVILLE
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State | FL
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Zip | 32578-9755
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Country | US
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Telephone | 850-821-2936
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Fax |
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Authorized Official
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Title or Position | PMHNP, OWNER
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Name | RACHAEL FLINT
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Credential |
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Telephone | 701-552-1508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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