Provider Demographics
NPI:1275951998
Name:MADDEN, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 W CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-4327
Mailing Address - Country:US
Mailing Address - Phone:702-619-6237
Mailing Address - Fax:
Practice Address - Street 1:25772 HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:PIOCHE
Practice Address - State:NV
Practice Address - Zip Code:89043-2597
Practice Address - Country:US
Practice Address - Phone:702-619-6237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner