Provider Demographics
NPI:1396730685
Name:EPPERSON, RACHEL A (APBC,RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:APBC,RN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1050 REID PARKWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374
Mailing Address - Country:US
Mailing Address - Phone:765-966-5217
Mailing Address - Fax:765-966-5277
Practice Address - Street 1:1050 REID PARKWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374
Practice Address - Country:US
Practice Address - Phone:765-966-5217
Practice Address - Fax:765-966-5277
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001018A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200272160AMedicaid
INP15358Medicare UPIN
IN500015328Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IN905920DMedicare ID - Type Unspecified
IN940940Medicare PIN