Provider Demographics
NPI:1396225462
Name:MOORE, RACHEL MASTERS (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MASTERS
Last Name:MOORE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:REBEKAH
Other - Last Name:MASTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1959 CLEARMONT ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1361
Mailing Address - Country:US
Mailing Address - Phone:478-335-1570
Mailing Address - Fax:
Practice Address - Street 1:2451 USA MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-471-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-144490163W00000X, 363LF0000X
FLRN9480788163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse