Provider Demographics
NPI:1407109424
Name:BIDWELL, RACHEL RENEE (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:RENEE
Last Name:BIDWELL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:RENEE
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:700 ACKERMAN RD STE 570
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1579
Mailing Address - Country:US
Mailing Address - Phone:614-293-8746
Mailing Address - Fax:614-293-6720
Practice Address - Street 1:300 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1280
Practice Address - Country:US
Practice Address - Phone:614-293-8746
Practice Address - Fax:614-293-6720
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13435363LA2100X
OHCOA.13435-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0078661Medicaid