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Individual

RACHEL CHACKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC, CCRN

Contact information

Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-5111
(313) 745-3500
Mailing address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-5111
(313) 745-3500

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704350190
MI
363L00000X
Nurse Practitioner
Primary
4704350190
MI
363LA2100X
Acute Care Nurse Practitioner
4704350190
MI

Other

Enumeration date
04/23/2024
Last updated
10/23/2024
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