Provider Demographics
NPI:1689221954
Name:HOWARD, RACHEAL CAMEREAL (DNP, CRNA)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:CAMEREAL
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CREWS STORE RD
Mailing Address - Street 2:
Mailing Address - City:BRUCETON
Mailing Address - State:TN
Mailing Address - Zip Code:38317-6011
Mailing Address - Country:US
Mailing Address - Phone:731-307-7458
Mailing Address - Fax:
Practice Address - Street 1:620 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3923
Practice Address - Country:US
Practice Address - Phone:731-541-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN124348367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered