Provider Demographics
NPI:1760244230
Name:DELBOS, RACHEL GROSS
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:GROSS
Last Name:DELBOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-8083
Mailing Address - Country:US
Mailing Address - Phone:757-683-4297
Mailing Address - Fax:
Practice Address - Street 1:1881 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-8083
Practice Address - Country:US
Practice Address - Phone:757-683-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0001312656163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163W00000XNursing Service ProvidersRegistered Nurse