Provider Demographics
NPI:1477742633
Name:CLINGENPEEL, RACHEL ANNE (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:CLINGENPEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY
Mailing Address - Street 2:SLOT #512-24A
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1013
Mailing Address - Fax:501-364-3939
Practice Address - Street 1:1 CHILDRENS WAY
Practice Address - Street 2:SLOT #512-24A
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1013
Practice Address - Fax:501-364-3939
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD12985208000000X
ARE-77382080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI001185701Medicare PIN