Provider Demographics
NPI:1134891260
Name:GUERRA, RACHEL LEIGH (APRON)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEIGH
Last Name:GUERRA
Suffix:
Gender:F
Credentials:APRON
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEIGH
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1565 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1565 HEATHER DR
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1340
Practice Address - Country:US
Practice Address - Phone:810-656-5636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704291455363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care