Provider Demographics
NPI:1326675448
Name:ULMER, RACHEL LUCILLE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LUCILLE
Last Name:ULMER
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58042-0015
Mailing Address - Country:US
Mailing Address - Phone:701-388-6035
Mailing Address - Fax:
Practice Address - Street 1:316 PRAIRIE DR
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:ND
Practice Address - Zip Code:58042-0015
Practice Address - Country:US
Practice Address - Phone:701-388-6035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33553208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics