Provider Demographics
NPI:1578119947
Name:DENLY, RACHAEL LEEANN
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LEEANN
Last Name:DENLY
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 1:609 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52626-9220
Mailing Address - Country:US
Mailing Address - Phone:319-470-0946
Mailing Address - Fax:
Practice Address - Street 1:609 S 5TH ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:IA
Practice Address - Zip Code:52626-9220
Practice Address - Country:US
Practice Address - Phone:319-470-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider