Provider Demographics
NPI:1598315111
Name:PURCELL, RACHEL ELAINE (MS, ATC)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ELAINE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15930 N BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8844
Mailing Address - Country:US
Mailing Address - Phone:949-378-8461
Mailing Address - Fax:623-322-3148
Practice Address - Street 1:15930 N BULLARD AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8844
Practice Address - Country:US
Practice Address - Phone:949-378-8461
Practice Address - Fax:623-322-3148
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty