Provider Demographics
NPI:1598328163
Name:HUYNH, RACHEL CATHERINE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CATHERINE
Last Name:HUYNH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:CATHERINE
Other - Last Name:WOHLFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7001 ROGERS AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4034
Mailing Address - Country:US
Mailing Address - Phone:479-785-2229
Mailing Address - Fax:479-478-6745
Practice Address - Street 1:7001 ROGERS AVE STE 403
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4034
Practice Address - Country:US
Practice Address - Phone:479-785-2229
Practice Address - Fax:479-478-6745
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health