Provider Demographics
NPI:1144237512
Name:RACHELS, NANCY JEAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JEAN
Last Name:RACHELS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 BENJAMIN H HILL DR W
Mailing Address - Street 2:P.O. DRAWER 840
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-8694
Mailing Address - Country:US
Mailing Address - Phone:229-423-9471
Mailing Address - Fax:
Practice Address - Street 1:320 BENJAMIN H HILL DR W
Practice Address - Street 2:P.O. DRAWER 840
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-8694
Practice Address - Country:US
Practice Address - Phone:229-423-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10708122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist