Provider Demographics
NPI:1033741491
Name:MORIN, RACHEL KRISTEN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KRISTEN
Last Name:MORIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14020 SE 106TH ST
Mailing Address - Street 2:
Mailing Address - City:OCKLAWAHA
Mailing Address - State:FL
Mailing Address - Zip Code:32179-4266
Mailing Address - Country:US
Mailing Address - Phone:352-430-4120
Mailing Address - Fax:
Practice Address - Street 1:10710 STATE ROAD 54 STE 108
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-2263
Practice Address - Country:US
Practice Address - Phone:727-376-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily