Provider Demographics
NPI:1033843511
Name:AMOS, RACHEL ANN (RT, RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:AMOS
Suffix:
Gender:F
Credentials:RT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13345 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3318
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-352-3417
Practice Address - Street 1:13345 ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3318
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-352-3417
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INXT017824247100000X
IN28275225A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist