Provider Demographics
NPI:1144198201
Name:KEITH, RACHEL (RN)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:KEITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:AZAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:108 NOTTOWAY DR
Mailing Address - Street 2:
Mailing Address - City:PENLLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1106
Mailing Address - Country:US
Mailing Address - Phone:954-664-9419
Mailing Address - Fax:
Practice Address - Street 1:108 NOTTOWAY DR
Practice Address - Street 2:
Practice Address - City:PENLLYN
Practice Address - State:PA
Practice Address - Zip Code:19422-1106
Practice Address - Country:US
Practice Address - Phone:954-664-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9544233163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty