Provider Demographics
NPI:1164766275
Name:WEST, RACHEL LYNNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNNE
Last Name:WEST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:LYNNE
Other - Last Name:GANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15126 DUNWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5854
Mailing Address - Country:US
Mailing Address - Phone:952-457-5064
Mailing Address - Fax:
Practice Address - Street 1:15126 DUNWOOD TRL
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5854
Practice Address - Country:US
Practice Address - Phone:952-457-5064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN072468-7164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse