Provider Demographics
NPI:1053494088
Name:LINGNAU, RACHEL GABRIEL (AUD CCCA FAAA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:GABRIEL
Last Name:LINGNAU
Suffix:
Gender:F
Credentials:AUD CCCA FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 50TH STREET
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414
Mailing Address - Country:US
Mailing Address - Phone:806-799-8950
Mailing Address - Fax:806-792-9404
Practice Address - Street 1:2909 NORTH PRINCE STREET
Practice Address - Street 2:STE 1
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:505-762-5355
Practice Address - Fax:505-762-1999
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51650237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80364AOtherBLUE CROSS BLUE SHIELD
NM46407871Medicaid
NMNM00E277OtherBLUE CROSS BLUE SHIELD