Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 235732 | CA |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95011778 | CA |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | APA60839107 | WA |
NPI | 1104229483 |
---|---|
Provider Name | Rachael Adair |
First Address | Fortuna, CA 95540-3814 |
Second Address | Fortuna, CA 95540-3119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2014 |
Last Update Date | 14/10/2021 |