Provider Demographics
NPI:1861207383
Name:DALLY, RACHAEL
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:DALLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:606 COURT ST
Mailing Address - Street 2:
Mailing Address - City:GIBBON
Mailing Address - State:NE
Mailing Address - Zip Code:68840-6003
Mailing Address - Country:US
Mailing Address - Phone:308-224-7564
Mailing Address - Fax:
Practice Address - Street 1:606 COURT ST
Practice Address - Street 2:
Practice Address - City:GIBBON
Practice Address - State:NE
Practice Address - Zip Code:68840-6003
Practice Address - Country:US
Practice Address - Phone:308-224-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion