Provider Demographics
NPI:1831983782
Name:GARDNER, RACHEL CAVANAH (RN, SRNA)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CAVANAH
Last Name:GARDNER
Suffix:
Gender:F
Credentials:RN, SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 COX MILL RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1213
Mailing Address - Country:US
Mailing Address - Phone:270-889-3681
Mailing Address - Fax:
Practice Address - Street 1:1375 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1656
Practice Address - Country:US
Practice Address - Phone:270-809-2193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1162688163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse