Provider Demographics
NPI:1912548744
Name:TAVES, RACHEL JANET (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JANET
Last Name:TAVES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:JANET
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 LIBERTY DR SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1832
Mailing Address - Country:US
Mailing Address - Phone:319-541-9198
Mailing Address - Fax:
Practice Address - Street 1:1940 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5378
Practice Address - Country:US
Practice Address - Phone:319-364-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH156355363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner