Basic Information
| Provider Information | |||||||||
| NPI: | 1639714637 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALTMAN | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | EMILY | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 COLONY LN | ||||||||
| Address2: | |||||||||
| City: | BRATENAHL | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441081180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164014882 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5001 ROCKSIDE RD | ||||||||
| Address2: | |||||||||
| City: | INDEPENDENCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441312172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169864000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2019 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | RN.443413 | OH | N | Nursing Service Providers | Registered Nurse | Pediatrics | 363LF0000X | APRN.CNP.026555 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.