MEDICARE: MRS. RACHAEL MAE HUGILL 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
1	163W00000X	Registered Nurse	401623	OH

General Provider Information

NPI Number	:	1598352759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHAEL MAE HUGILL RN

Provider Business Mailing Address
First Line	:	2324 SPRINGLAKE RD
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685
Country	:	US
Telephone Number	:	330-858-4975
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 N CLEVELAND AVE
Second Line	:
City	:	MOGADORE
State	:	OH
Zip	:	44260-1365
Country	:	US
Telephone Number	:	330-858-4975
Fax Number	:

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

Provider Enumeration Date	:	12/22/2020
Last Update Date	:	05/22/2023

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