Provider Demographics
NPI:1548909112
Name:GARRETT, RACHEL JANE (RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:OREANA
Mailing Address - State:IL
Mailing Address - Zip Code:62554-0192
Mailing Address - Country:US
Mailing Address - Phone:217-521-5917
Mailing Address - Fax:
Practice Address - Street 1:310 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:OREANA
Practice Address - State:IL
Practice Address - Zip Code:62554-7903
Practice Address - Country:US
Practice Address - Phone:217-521-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041462735163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse