Provider Demographics
NPI:1780864744
Name:PITOT, RACHEL AUTUMN (RN)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:AUTUMN
Last Name:PITOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3305
Mailing Address - Country:US
Mailing Address - Phone:617-288-0970
Mailing Address - Fax:
Practice Address - Street 1:1140 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-3305
Practice Address - Country:US
Practice Address - Phone:617-288-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270006163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse