Basic Information
| Provider Information | |||||||||
| NPI: | 1497726319 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | EFFOLIA | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 236 EMERSON DR NW | ||||||||
| Address2: | |||||||||
| City: | PALM BAY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329077897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3219524914 | ||||||||
| FaxNumber: | 3217278740 | ||||||||
| Practice Location | |||||||||
| Address1: | VA OUTPATIENT CLINIC | ||||||||
| Address2: | 2900 VETERANS WAY | ||||||||
| City: | VIERA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216373788 | ||||||||
| FaxNumber: | 3216373507 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 10/26/2007 | ||||||||
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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 | ARNP 3137612 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.