MEDICARE: RACHEL SUSANNE MINARD

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	163WH0200X	Home Health Registered Nurse	32256	WV

General Provider Information

NPI Number	:	1255193538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SUSANNE MINARD

Provider Business Mailing Address
First Line	:	2673 DAVISSON RUN RD STE 201
Second Line	:
City	:	CLARKSBURG
State	:	WV
Zip	:	26301-6838
Country	:	US
Telephone Number	:	681-342-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2673 DAVISSON RUN RD STE 201
Second Line	:
City	:	CLARKSBURG
State	:	WV
Zip	:	26301-6838
Country	:	US
Telephone Number	:	681-342-3200
Fax Number	:

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

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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Directions to “ RACHEL SUSANNE MINARD ” Practice Location

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