Provider Demographics
NPI:1922465525
Name:KENYON, RACHEL ALISON (CRNA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALISON
Last Name:KENYON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:SHREEVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 637578
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7578
Mailing Address - Country:US
Mailing Address - Phone:866-358-1499
Mailing Address - Fax:407-390-1765
Practice Address - Street 1:40100 HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5906
Practice Address - Country:US
Practice Address - Phone:863-419-2399
Practice Address - Fax:863-419-2405
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265115367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered