Basic Information
| Provider Information | |||||||||
| NPI: | 1417317017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | APRN, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 SOUTHWOOD DRIVE | ||||||||
| Address2: | FAMILY MEDICINE | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035774440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 HITCHCOCK WAY | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031044125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2016 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 062714-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1032858 | 05 | VT | MEDICAID | 3112209 | 05 | NH | MEDICAID |