Provider Demographics
NPI:1144763244
Name:MAPLE, RACHEL (CNA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MAPLE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:IL
Mailing Address - Zip Code:61734-9312
Mailing Address - Country:US
Mailing Address - Phone:309-202-5266
Mailing Address - Fax:
Practice Address - Street 1:608 E 8TH ST
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:IL
Practice Address - Zip Code:61734-9312
Practice Address - Country:US
Practice Address - Phone:309-202-5266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide