Provider Demographics
NPI:1841267432
Name:RASHIDIAN, RAYSHA RENEE (DC)
Entity type:Individual
Prefix:
First Name:RAYSHA
Middle Name:RENEE
Last Name:RASHIDIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2712
Mailing Address - Country:US
Mailing Address - Phone:270-826-5737
Mailing Address - Fax:
Practice Address - Street 1:1023 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2712
Practice Address - Country:US
Practice Address - Phone:270-826-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000379369OtherANTHEM BLUE CROSS BLUE SH
KY6106601Medicare ID - Type Unspecified