Provider Demographics
NPI:1083939938
Name:STANZE, RACHAEL LYNN
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LYNN
Last Name:STANZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E. 4TH STREET
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805
Mailing Address - Country:US
Mailing Address - Phone:612-801-4419
Mailing Address - Fax:
Practice Address - Street 1:1420 E. 4TH STREET
Practice Address - Street 2:APARTMENT 2
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805
Practice Address - Country:US
Practice Address - Phone:612-801-4419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula