Provider Demographics
NPI:1427587120
Name:COMPEAU, RACHAEL ELIZABETH (NP)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:COMPEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ELIZABETH
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 MILLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1643
Mailing Address - Country:US
Mailing Address - Phone:810-496-5777
Mailing Address - Fax:810-496-5798
Practice Address - Street 1:725 MASON ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-496-5777
Practice Address - Fax:810-496-5798
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2019-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily