Provider Demographics
NPI:1689954034
Name:RAKACZKI, EMILY D (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:D
Last Name:RAKACZKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:D
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR STREET, SUITE 601
Mailing Address - Street 2:HARTFORD HOSPITAL PRE-ADMISSION CENTER
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5525
Mailing Address - Country:US
Mailing Address - Phone:860-972-2334
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR STREET, SUITE 601
Practice Address - Street 2:HARTFORD HOSPITAL PRE-ADMISSION CENTER
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5525
Practice Address - Country:US
Practice Address - Phone:860-972-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332301363L00000X
CT007385363L00000X, 363LF0000X
NM336800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner