Provider Demographics
NPI:1629369541
Name:EGAN, RACHEL TURNER (OTR/L MS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:TURNER
Last Name:EGAN
Suffix:
Gender:F
Credentials:OTR/L MS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:JEAN
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L MS
Mailing Address - Street 1:2104 NORTHDALE BLVD NW STE 100
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-3045
Mailing Address - Country:US
Mailing Address - Phone:763-755-5495
Mailing Address - Fax:763-862-0342
Practice Address - Street 1:2104 NORTHDALE BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-3028
Practice Address - Country:US
Practice Address - Phone:763-755-5495
Practice Address - Fax:763-862-0342
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104032225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist