Provider Demographics
NPI:1841968088
Name:SHAPELOW, RACHAEL MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MARIE
Last Name:SHAPELOW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 VENUE WAY APT 6108
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4551
Mailing Address - Country:US
Mailing Address - Phone:240-446-5272
Mailing Address - Fax:
Practice Address - Street 1:3260 POINTE PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-3345
Practice Address - Country:US
Practice Address - Phone:770-685-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN304220363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care