Provider Demographics
NPI:1205309333
Name:SHAVER, RACHEL ANN (NNP, APRN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:SHAVER
Suffix:
Gender:F
Credentials:NNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 HEPHZIBAH MCBEAN RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-4330
Mailing Address - Country:US
Mailing Address - Phone:706-373-8199
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-2629
Practice Address - Country:US
Practice Address - Phone:706-721-3813
Practice Address - Fax:706-721-1459
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN174883163W00000X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse