Rachael Ellen Dewalt, LPN
Individual provider Active NPI Licensed Practical Nurse · Newcomerstown, OH
NPI 1306131388 · NPPES record last updated Jun 17, 2011
Key facts
- NPI
- 1306131388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 118436 (OH)
- Practice address
- 14080 Washington Ave
Newcomerstown, OH 43832-9068 - Phone
- (330) 447-7256
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118436 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 118436 | OH | Yes |
Addresses
Primary practice location
14080 Washington Ave
Newcomerstown, OH 43832-9068
Mailing address
14080 Washington Ave
Newcomerstown, OH 43832-9068
Phone (330) 447-7256
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All providers in Newcomerstown, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.