Provider Demographics
NPI:1568771178
Name:COLVIN, RACHEL (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:COLVIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 LAKE KRISTIN DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-8345
Mailing Address - Country:US
Mailing Address - Phone:504-457-1630
Mailing Address - Fax:
Practice Address - Street 1:3508 LAKE KRISTIN DR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-8345
Practice Address - Country:US
Practice Address - Phone:504-457-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN113020-AP06205363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily