Provider Demographics
NPI:1336908953
Name:FANCHER, RACHEL (RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:FANCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W BRANDON BLVD # 150
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5103
Mailing Address - Country:US
Mailing Address - Phone:321-443-0870
Mailing Address - Fax:
Practice Address - Street 1:205 W SHELL POINT RD
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-3706
Practice Address - Country:US
Practice Address - Phone:321-443-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9350808163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy