Provider Demographics
NPI:1306391248
Name:CODD, RACHEL ISABELL (DNP, AGACNP-BC, RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ISABELL
Last Name:CODD
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC, RN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:BETH
Other - Last Name:ISABELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1873 WILLIAMS HWY STE 1B
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5843
Mailing Address - Country:US
Mailing Address - Phone:541-218-3370
Mailing Address - Fax:541-476-0541
Practice Address - Street 1:1212 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1424
Practice Address - Country:US
Practice Address - Phone:541-218-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-21
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6128225700000X
OR10019924363LA2100X
OR201905841RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care