Provider Demographics
NPI:1447537725
Name:BORES, RACHEL L (STNA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:BORES
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44847-9792
Mailing Address - Country:US
Mailing Address - Phone:216-374-1806
Mailing Address - Fax:
Practice Address - Street 1:107 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44847-9792
Practice Address - Country:US
Practice Address - Phone:216-374-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401228380411376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide