Provider Demographics
NPI:1023459666
Name:NAULT, RACHEL (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NAULT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BRANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:N5775 OLD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-5322
Mailing Address - Country:US
Mailing Address - Phone:920-213-5800
Mailing Address - Fax:
Practice Address - Street 1:100 COUNTY ROAD B
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166
Practice Address - Country:US
Practice Address - Phone:715-524-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17055-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist