Basic Information
| Provider Information | |||||||||
| NPI: | 1609429307 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EYRE | ||||||||
| FirstName: | RACHELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 882014 | ||||||||
| Address2: | |||||||||
| City: | STEAMBOAT SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804882014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709032838 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2101 BOX BUTTE AVE | ||||||||
| Address2: | |||||||||
| City: | ALLIANCE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 693014445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3087626660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2019 | ||||||||
| LastUpdateDate: | 08/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1017259 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 112884 | NE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.