Provider Demographics
NPI:1356071658
Name:WARREN, RACHEL (NP-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6890 BELFORT OAKS PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6241
Mailing Address - Country:US
Mailing Address - Phone:904-296-1313
Mailing Address - Fax:
Practice Address - Street 1:6890 BELFORT OAKS PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6241
Practice Address - Country:US
Practice Address - Phone:904-296-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11210025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily