Provider Demographics
NPI:1609488592
Name:COTTRILL, RACHAEL L (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:L
Last Name:COTTRILL
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6859 MILLERS RUN FALLEN TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648-8849
Mailing Address - Country:US
Mailing Address - Phone:740-222-9440
Mailing Address - Fax:
Practice Address - Street 1:6859 MILLERS RUN FALLEN TIMBER RD
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45648-8849
Practice Address - Country:US
Practice Address - Phone:740-222-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351708163WE0003X
OHAPRN.CNP.0027544363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency