Provider Demographics
NPI:1295509487
Name:THEILER, RACHEL K (NTP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:K
Last Name:THEILER
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:K
Other - Last Name:THEILER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NTP
Mailing Address - Street 1:306 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-1120
Mailing Address - Country:US
Mailing Address - Phone:502-905-0851
Mailing Address - Fax:
Practice Address - Street 1:306 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-1120
Practice Address - Country:US
Practice Address - Phone:502-905-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education