Basic Information
| Provider Information | |||||||||
| NPI: | 1154059939 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROWE | ||||||||
| FirstName: | RACHALL | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2745 21ST ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958183143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343064934 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 SUTTER PL | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956166201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307575111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2022 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WE0003X | 1-108542 | AL | N | Nursing Service Providers | Registered Nurse | Emergency | 163WE0003X | RN312476 | GA | N | Nursing Service Providers | Registered Nurse | Emergency | 163WE0003X | 95026035 | CA | N | Nursing Service Providers | Registered Nurse | Emergency | 363LF0000X | 95022167 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.