Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 18996 | CA |
NPI | 1003046061 |
---|---|
Provider Name | Rachelle C Allwardt |
First Address | Carmichael, CA 95608-1496 |
Second Address | Carmichael, CA 95608-1496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2009 |
Last Update Date | 01/11/2013 |