Provider Demographics
NPI:1285662924
Name:RACHELS, CHERYL R (CFNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:R
Last Name:RACHELS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8798
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:910-695-1751
Practice Address - Street 1:1902C NORTH SANDHILLS BLVD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2347
Practice Address - Country:US
Practice Address - Phone:910-692-4011
Practice Address - Fax:910-695-1751
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003798Medicaid
NCFH4000135OtherFCC PROVIDER NUMBER
SCNP0961OtherSC MEDICAID PROVIDER#
NC2592206DMedicare ID - Type Unspecified
S72322Medicare UPIN