Provider Demographics
NPI:1275011017
Name:FARISH, RACHAEL PITTS (FNP)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:PITTS
Last Name:FARISH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 KIRKWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5121
Mailing Address - Country:US
Mailing Address - Phone:828-754-0101
Mailing Address - Fax:828-757-0402
Practice Address - Street 1:1721 ENON RD
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-9314
Practice Address - Country:US
Practice Address - Phone:828-879-1601
Practice Address - Fax:828-874-1403
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010719363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5010719OtherNCBON/MEDICAL BOARD