Provider Demographics
NPI:1316365091
Name:DOOLEN, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DOOLEN
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 1:1300 N 9TH AVE
Mailing Address - Street 2:APT 3Q
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-2683
Mailing Address - Country:US
Mailing Address - Phone:715-218-4932
Mailing Address - Fax:
Practice Address - Street 1:1300 N 9TH AVE
Practice Address - Street 2:APT 3Q
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2683
Practice Address - Country:US
Practice Address - Phone:715-218-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI317802164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse