Provider Demographics
NPI:1609051218
Name:NISBET, RACHEL ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:NISBET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2075 HAMILTON CREEK PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7285
Mailing Address - Country:US
Mailing Address - Phone:770-586-0300
Mailing Address - Fax:
Practice Address - Street 1:2075 HAMILTON CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7285
Practice Address - Country:US
Practice Address - Phone:770-586-0300
Practice Address - Fax:770-586-0311
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054828207R00000X, 207RC0200X, 207RP1001X, 207RP1001X, 207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA551442576AMedicaid
GA551442576AMedicaid