Provider Demographics
NPI:1205548252
Name:GRANDSTRAND, RACHEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GRANDSTRAND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SADDLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-1639
Mailing Address - Country:US
Mailing Address - Phone:310-991-3427
Mailing Address - Fax:
Practice Address - Street 1:17 SADDLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:MA
Practice Address - Zip Code:02030-1639
Practice Address - Country:US
Practice Address - Phone:310-991-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program