Provider Demographics
NPI:1649662479
Name:PENA, RACHEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:PENA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7488 WINE CREEK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5397
Mailing Address - Country:US
Mailing Address - Phone:240-672-3329
Mailing Address - Fax:
Practice Address - Street 1:11001 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2954
Practice Address - Country:US
Practice Address - Phone:702-948-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist