Provider Demographics
NPI:1356838361
Name:BEAL, RACHEL MICHELLE (LVN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MICHELLE
Last Name:BEAL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 E COUNTY ROAD 423
Mailing Address - Street 2:
Mailing Address - City:MAY
Mailing Address - State:TX
Mailing Address - Zip Code:76857-2900
Mailing Address - Country:US
Mailing Address - Phone:325-998-6662
Mailing Address - Fax:
Practice Address - Street 1:1301 E COUNTY ROAD 423
Practice Address - Street 2:
Practice Address - City:MAY
Practice Address - State:TX
Practice Address - Zip Code:76857-2900
Practice Address - Country:US
Practice Address - Phone:325-998-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX177299164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse