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NPI Code Detail

MEDICARE: RACHAEL SCHALLER

MEDICARE: RACHAEL SCHALLER
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
1363LF0000XFamily Nurse Practitioner12.009859CT

General Provider Information

NPI Number : 1417622333
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL SCHALLER
Provider Business Mailing Address
First Line : 1057 BOSTON POST RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-2644
Country : US
Telephone Number : 203-458-1444
Fax Number :
Provider Business Practice Location Address
First Line : 1057 BOSTON POST RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-2644
Country : US
Telephone Number : 203-458-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2021
Last Update Date : 03/30/2022

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