Basic Information
| Provider Information | |||||||||
| NPI: | 1316290448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WANZOR-BOX | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | NOLENE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5980 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794085980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610878 | ||||||||
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| Practice Location | |||||||||
| Address1: | 602 INDIANA AVE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794153364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610878 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2012 | ||||||||
| LastUpdateDate: | 05/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SF0001X | CNP-02072 | NM | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Family Health | 363LF0000X | AP122711 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.