Basic Information
| Provider Information | |||||||||
| NPI: | 1265424055 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWEENEY | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | C.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 BENFIELD BLVD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211083002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107298100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1509 RITCHIE HWY | ||||||||
| Address2: | |||||||||
| City: | ARNOLD | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210122742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107577600 | ||||||||
| FaxNumber: | 4106268043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2005 | ||||||||
| LastUpdateDate: | 01/24/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R127373 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 658804200 | 05 | MD | MEDICAID | 617094-01 | 01 | MD | CAREFIRST MD RENDERING | OTHER | 6284608 | 01 | MD | AETNA HMO | OTHER | 7149758 | 01 | MD | AETNA PPO | OTHER | 38282 | 01 | MD | JHHC PROVIDER NUMBER | OTHER | 500006588 | 01 | MD | RAILROAD MEDICARE | OTHER | 7605-0037 | 01 | MD | CAREFIRST BLUECHOICE | OTHER |