MEDICARE: MRS. HEATHER RENEE RACHAL CPNP-AC/PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0222X	Critical Care Pediatric Nurse Practitioner	AP05266	LA
2	363LP0200X	Pediatric Nurse Practitioner	AP05266	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023202207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER RENEE RACHAL CPNP-AC/PC

Provider Business Mailing Address
First Line	:	5719 MILDRED AVE
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-2827
Country	:	US
Telephone Number	:	318-487-0606
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 BREVARD CT STE D
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-3997
Country	:	US
Telephone Number	:	318-777-6887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/13/2025

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