Provider Demographics
NPI:1417551334
Name:VULTAGGIO, RACHEL M (LPN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:VULTAGGIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CROWNE POINT PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-5427
Mailing Address - Country:US
Mailing Address - Phone:513-743-7628
Mailing Address - Fax:513-737-1107
Practice Address - Street 1:6570 SOSNA DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2222
Practice Address - Country:US
Practice Address - Phone:513-942-4673
Practice Address - Fax:513-860-1439
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136230164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse