Provider Demographics
NPI:1871283788
Name:GAY, RACHEL NICOLE (RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:GAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 BLUE MOUNT RD
Mailing Address - Street 2:
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-1234
Mailing Address - Country:US
Mailing Address - Phone:443-909-0035
Mailing Address - Fax:
Practice Address - Street 1:1501 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5730
Practice Address - Country:US
Practice Address - Phone:443-909-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse