MEDICARE: RACHEL N BRINSON

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	363L00000X	Nurse Practitioner	71009180A	IN

General Provider Information

NPI Number	:	1093277295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL N BRINSON

Provider Business Mailing Address
First Line	:	PO BOX 749495
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9495
Country	:	US
Telephone Number	:	855-963-2100
Fax Number	:	813-321-1296

Provider Business Practice Location Address
First Line	:	7910 W JEFFERSON BLVD STE 108
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4159
Country	:	US
Telephone Number	:	260-436-0800
Fax Number	:	260-483-1911

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

Provider Enumeration Date	:	04/05/2019
Last Update Date	:	01/06/2026

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Directions to “ RACHEL N BRINSON ” Practice Location

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