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Individual

RACHEL BETH PRUSAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-49579
HI
163W00000X
Registered Nurse
RN140381
LA
363LF0000X
Family Nurse Practitioner
Primary
201501099NP-PP
OR
363LF0000X
Family Nurse Practitioner
612484
CA
363LF0000X
Family Nurse Practitioner
AP07265
LA
363LF0000X
Family Nurse Practitioner
APRN-1283
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500696121
OR
Enumeration date
02/26/2008
Last updated
12/07/2021
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