Provider Demographics
NPI:1598274763
Name:DAVIS, RACHEL ANN (PBT (ASCP))
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PBT (ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14637 REVERE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7044
Mailing Address - Country:US
Mailing Address - Phone:440-310-4561
Mailing Address - Fax:
Practice Address - Street 1:14637 REVERE CIR
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7044
Practice Address - Country:US
Practice Address - Phone:440-317-3178
Practice Address - Fax:440-310-4561
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201724002256246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy