Provider Demographics
NPI:1881665008
Name:WITHERSPOON, RACHEL LYNN (RDH)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:WITHERSPOON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 1005 BOX 25
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09593
Mailing Address - Country:US
Mailing Address - Phone:0115-399-7154
Mailing Address - Fax:
Practice Address - Street 1:COMMANDING OFFICER US NAVAL HOSPITAL
Practice Address - Street 2:ATTN. DENTAL CLINIC
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589-1000
Practice Address - Country:US
Practice Address - Phone:01153-997-2241
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003334124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist