Provider Demographics
NPI:1942975206
Name:TAYLOR, RACHEL RAGINA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:RAGINA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RAGINA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2085 DOOLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-2346
Mailing Address - Country:US
Mailing Address - Phone:706-499-6097
Mailing Address - Fax:
Practice Address - Street 1:2085 DOOLEY RD
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-2346
Practice Address - Country:US
Practice Address - Phone:706-499-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209116163WG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0600XNursing Service ProvidersRegistered NurseGerontology