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Individual

RACHEL JAYNU NIMELY-SCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
5722 KINGMAN AVE, PORTAGE, IN 46368-1529
(773) 240-2528
Mailing address
5722 KINGMAN AVE, PORTAGE, IN 46368-1529
(773) 240-2528

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.019816
IL

Other

Enumeration date
09/16/2019
Last updated
09/16/2019
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