Provider Demographics
NPI:1225407976
Name:LEBRUN, RACHEL (NP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LEBRUN
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:ELCCC
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-346-7655
Mailing Address - Fax:760-346-7651
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:ELCCC
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-7655
Practice Address - Fax:760-346-7651
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95001827363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health