Provider Demographics
NPI:1578006193
Name:SIEPS, RACHEL DAWN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DAWN
Last Name:SIEPS
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 1:261 5TH ST E
Mailing Address - Street 2:APT 208
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2581
Mailing Address - Country:US
Mailing Address - Phone:720-838-4463
Mailing Address - Fax:
Practice Address - Street 1:261 5TH ST E
Practice Address - Street 2:APT 208
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2581
Practice Address - Country:US
Practice Address - Phone:720-838-4463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR232984-4163W00000X
CO0166249163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse