Provider Demographics
NPI:1639476906
Name:STOCK, RACHEL LEE (RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:STOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEE
Other - Last Name:BIGKNIFE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:P.O. BOX 880
Mailing Address - Street 2:
Mailing Address - City:ST. IGNATIUS
Mailing Address - State:MT
Mailing Address - Zip Code:59865
Mailing Address - Country:US
Mailing Address - Phone:406-745-3525
Mailing Address - Fax:406-745-3529
Practice Address - Street 1:308 MISSION DR
Practice Address - Street 2:
Practice Address - City:ST IGNATIUS
Practice Address - State:MT
Practice Address - Zip Code:59865
Practice Address - Country:US
Practice Address - Phone:406-883-5541
Practice Address - Fax:406-883-3193
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT26698163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse