Provider Demographics
NPI:1649745258
Name:MCREYNOLDS, RACHEL SHELTON (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHELTON
Last Name:MCREYNOLDS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RENE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1820 N 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-5048
Mailing Address - Country:US
Mailing Address - Phone:225-588-9030
Mailing Address - Fax:
Practice Address - Street 1:2725 S 144TH ST
Practice Address - Street 2:SUITE 110, 205, 212
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5243
Practice Address - Country:US
Practice Address - Phone:402-609-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1202112255A2300X
NE11392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer