Provider Demographics
NPI:1902238306
Name:FIELDS, RACHEL SUE (LPN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10123 MORRISON MIKESELL RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:45347-9022
Mailing Address - Country:US
Mailing Address - Phone:937-336-3382
Mailing Address - Fax:
Practice Address - Street 1:10123 MORRISON MIKESELL RD
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:OH
Practice Address - Zip Code:45347-9022
Practice Address - Country:US
Practice Address - Phone:937-336-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152006-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse