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NPI Code Detail

MEDICARE: MRS. RACHEL COOPER BRIESE PNP

MEDICARE: MRS. RACHEL COOPER BRIESE PNP
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
1363LP0200XPediatric Nurse Practitioner3003722KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13003722OTHERKYAPRN LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417141326
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHEL COOPER BRIESE PNP
Provider Business Mailing Address
First Line : 303 S 4TH ST
Second Line :
City : DANVILLE
State : KY
Zip : 40422-2091
Country : US
Telephone Number : 859-236-1080
Fax Number : 859-236-1862
Provider Business Practice Location Address
First Line : 303 S 4TH ST
Second Line :
City : DANVILLE
State : KY
Zip : 40422-2091
Country : US
Telephone Number : 859-236-1080
Fax Number : 859-236-1862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2007
Last Update Date : 03/22/2017

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