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NPI Code Detail

MEDICARE: RACHEL ROSE DAVISON RN

MEDICARE: RACHEL ROSE DAVISON RN
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
1163W00000XRegistered NurseRN95242363CA

General Provider Information

NPI Number : 1528649720
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL ROSE DAVISON RN
Provider Business Mailing Address
First Line : 1498 BROOKSIDE AVE APT 241I
Second Line :
City : REDLANDS
State : CA
Zip : 92373-4453
Country : US
Telephone Number : 530-933-8588
Fax Number :
Provider Business Practice Location Address
First Line : 2025 E WASHINGTON ST
Second Line :
City : COLTON
State : CA
Zip : 92324-4704
Country : US
Telephone Number : 909-824-8299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2021
Last Update Date : 04/19/2021

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