MEDICARE: RACHAEL NEUDECKER FNP

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	363LF0000X	Family Nurse Practitioner	185448	TN
2	363LF0000X	Family Nurse Practitioner	25084	TN

General Provider Information

NPI Number	:	1831664770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL NEUDECKER FNP

Provider Business Mailing Address
First Line	:	PO BOX 932958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 PORT ROYAL RD
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-2804
Country	:	US
Telephone Number	:	315-602-1649
Fax Number	:	931-560-2165

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

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	04/10/2025

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