Provider Demographics
NPI:1437782968
Name:DERSCH, RACHEL SHARON (RN, CD)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:SHARON
Last Name:DERSCH
Suffix:
Gender:F
Credentials:RN, CD
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:SHARON
Other - Last Name:BLANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1305 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5319
Mailing Address - Country:US
Mailing Address - Phone:334-717-3722
Mailing Address - Fax:
Practice Address - Street 1:1305 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5319
Practice Address - Country:US
Practice Address - Phone:334-717-3722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula