Provider Demographics
NPI:1326805003
Name:IANNCE, RACHEL BROOKE (NP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BROOKE
Last Name:IANNCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10655 SW 69TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-9339
Mailing Address - Country:US
Mailing Address - Phone:352-286-5783
Mailing Address - Fax:
Practice Address - Street 1:2815 SE 17TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5516
Practice Address - Country:US
Practice Address - Phone:352-286-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031466363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner