Provider Demographics
NPI:1922684919
Name:NELSON, RACHEL ALEXANDRA (DO)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALEXANDRA
Last Name:NELSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38302-0400
Mailing Address - Country:US
Mailing Address - Phone:731-423-8697
Mailing Address - Fax:731-425-5783
Practice Address - Street 1:101 GARRETT DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:TN
Practice Address - Zip Code:38355-9641
Practice Address - Country:US
Practice Address - Phone:731-422-0355
Practice Address - Fax:731-462-5070
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDO5468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine