Provider Demographics
NPI:1063060564
Name:MARISCAL, RACHEL (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MARISCAL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 N CENTRAL EXPY STE 420
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5945
Mailing Address - Country:US
Mailing Address - Phone:214-820-8220
Mailing Address - Fax:
Practice Address - Street 1:9101 N CENTRAL EXPY STE 420
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5945
Practice Address - Country:US
Practice Address - Phone:214-820-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily