Provider Demographics
NPI:1881477610
Name:GOOD, RACHEL ALEXANDRA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALEXANDRA
Last Name:GOOD
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 1:20301 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-9612
Mailing Address - Country:US
Mailing Address - Phone:405-664-6354
Mailing Address - Fax:
Practice Address - Street 1:20301 KINGS RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-9612
Practice Address - Country:US
Practice Address - Phone:405-664-6354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program