Provider Demographics
NPI:1841447737
Name:HORSMAN, RACHAEL KRISTEN
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:KRISTEN
Last Name:HORSMAN
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 1:3809 21ST ST SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6035
Mailing Address - Country:US
Mailing Address - Phone:507-398-9540
Mailing Address - Fax:
Practice Address - Street 1:3809 21ST ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6035
Practice Address - Country:US
Practice Address - Phone:507-398-9540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN185213-4163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN02711775Medicaid