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

LicenseStateTypeSpecialty
118436OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Newcomerstown, OH

All providers in Newcomerstown, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.