Provider Demographics
NPI:1477236578
Name:CLARK, RACHEL ANN
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ANN
Last Name:CLARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 COMPASS WEST DR APT 10
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3427
Mailing Address - Country:US
Mailing Address - Phone:330-318-0926
Mailing Address - Fax:
Practice Address - Street 1:1031 COMPASS WEST DR APT 10
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3427
Practice Address - Country:US
Practice Address - Phone:330-318-0926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide