=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689508160
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL CHURCHILL RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2026
-----------------------------------------------------
Last Update Date | 06/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 419 E OLYMPIA AVE
-----------------------------------------------------
City | MANILA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72442-9182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-561-3145
-----------------------------------------------------
Fax | 870-561-8119
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 419 E OLYMPIA AVE
-----------------------------------------------------
City | MANILA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72442-9182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-561-3145
-----------------------------------------------------
Fax | 870-561-8119
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | R77382
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------