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General NPI Number Information
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NPI Number | 1881578243
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Entity Type | Individual
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Provider Name | RACHEL E MUDD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 10673 W LAKE HAZEL RD # 1032
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City | BOISE
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State | ID
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Zip | 83709-5453
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Country | US
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Telephone | 502-681-6241
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Fax |
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Provider Business Mailing Address
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Address Line | 4729 S WAKES PL
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City | BOISE
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State | ID
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Zip | 83709-8051
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Country | US
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Telephone | 502-681-6241
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Fax | 502-681-6241
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | ID
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