Provider Demographics
NPI:1528764032
Name:GORDON-TUPMAN, RACHAEL BROOKE-ANN (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:BROOKE-ANN
Last Name:GORDON-TUPMAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SABRINA CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4228
Mailing Address - Country:US
Mailing Address - Phone:770-301-7277
Mailing Address - Fax:
Practice Address - Street 1:221 SABRINA CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4228
Practice Address - Country:US
Practice Address - Phone:770-301-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN271333163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse