Provider Demographics
NPI:1780904219
Name:OEHLKE-DENDY, RACHEL E
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:E
Last Name:OEHLKE-DENDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16507 PAINT AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-5822
Mailing Address - Country:US
Mailing Address - Phone:225-964-1468
Mailing Address - Fax:225-218-4975
Practice Address - Street 1:16507 PAINT AVE
Practice Address - Street 2:
Practice Address - City:GREENWELL SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70739-5822
Practice Address - Country:US
Practice Address - Phone:225-964-1468
Practice Address - Fax:225-218-4975
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA36054173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine