Provider Demographics
NPI:1174889323
Name:FALLE, RACHAEL K (NP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:K
Last Name:FALLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:K
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2920 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1944
Mailing Address - Country:US
Mailing Address - Phone:920-452-6000
Mailing Address - Fax:920-803-2990
Practice Address - Street 1:2920 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-1944
Practice Address - Country:US
Practice Address - Phone:920-452-6000
Practice Address - Fax:920-803-2990
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4804-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health