Provider Demographics
NPI:1457642522
Name:CHAMPION, RACHEL WERGIN (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:WERGIN
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:DANA
Other - Last Name:WERGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-322-6485
Mailing Address - Fax:615-343-2591
Practice Address - Street 1:719 THOMPSON LN
Practice Address - Street 2:SUITE 26300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3609
Practice Address - Country:US
Practice Address - Phone:615-322-6485
Practice Address - Fax:615-343-2591
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000052599207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology