Provider Demographics
NPI:1760646517
Name:BURKE, RACHEL ANN (RP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:BURKE
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:KOHLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RP
Mailing Address - Street 1:601 N 30TH ST
Mailing Address - Street 2:SUITE 2807
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2137
Mailing Address - Country:US
Mailing Address - Phone:402-280-2605
Mailing Address - Fax:402-449-4531
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:SUITE 2807
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2137
Practice Address - Country:US
Practice Address - Phone:402-280-2605
Practice Address - Fax:402-449-4531
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist