Provider Demographics
NPI:1497798821
Name:BURNS, RACHEL (NP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:113 W HANSELL ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6664
Mailing Address - Country:US
Mailing Address - Phone:229-228-2410
Mailing Address - Fax:229-228-2490
Practice Address - Street 1:113 W HANSELL ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6664
Practice Address - Country:US
Practice Address - Phone:229-228-2410
Practice Address - Fax:229-228-2490
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3413652363L00000X
GARN231977363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307431500Medicaid
FL307431500Medicaid
FLU5121YMedicare PIN