Provider Demographics
NPI:1679982664
Name:NEIER, RACHEL RENELLE (RN, NNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENELLE
Last Name:NEIER
Suffix:
Gender:F
Credentials:RN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-556-6428
Mailing Address - Fax:417-556-6429
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-556-6428
Practice Address - Fax:417-556-6429
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026220363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200548300AMedicaid
MO1679982664Medicaid
KS20101440BMedicaid
MOMA2082439Medicare PIN