Provider Demographics
NPI:1316211212
Name:STUBBS, RACHEL COWAN (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:COWAN
Last Name:STUBBS
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 1:25 VISTA POINT DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-8906
Mailing Address - Country:US
Mailing Address - Phone:912-856-7904
Mailing Address - Fax:
Practice Address - Street 1:11382 N JACOB SMART BLVD STE D
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-2700
Practice Address - Country:US
Practice Address - Phone:843-441-9415
Practice Address - Fax:843-305-6107
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112208 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily