Provider Demographics
NPI:1649310228
Name:INCE, RACHAEL SUE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:SUE
Last Name:INCE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 212
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:OK
Mailing Address - Zip Code:73052-9157
Mailing Address - Country:US
Mailing Address - Phone:405-756-8641
Mailing Address - Fax:
Practice Address - Street 1:210 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:OK
Practice Address - Zip Code:73052-4048
Practice Address - Country:US
Practice Address - Phone:405-756-1414
Practice Address - Fax:405-756-1162
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0073454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily