Provider Demographics
NPI:1851990956
Name:CLERMONT, RACHELLE (RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:
Last Name:CLERMONT
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 WHITE CAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5545
Mailing Address - Country:US
Mailing Address - Phone:561-246-0809
Mailing Address - Fax:561-530-2023
Practice Address - Street 1:8616 WHITE CAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5545
Practice Address - Country:US
Practice Address - Phone:561-246-0809
Practice Address - Fax:561-530-2023
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9339813163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107234400Medicaid