Provider Demographics
NPI:1386229151
Name:DAVIDSON, RACHEL RENEE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENEE
Last Name:DAVIDSON
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 1:1100 ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0924
Mailing Address - Country:US
Mailing Address - Phone:931-520-4466
Mailing Address - Fax:931-520-3871
Practice Address - Street 1:5880 BRADFORD HICKS DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-2236
Practice Address - Country:US
Practice Address - Phone:931-823-6260
Practice Address - Fax:931-823-5821
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily