Basic Information
Provider Information
NPI: 1477297737
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIMLICH
FirstName: RACHAEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26500 AKINS RD
Address2:  
City: COLUMBIA STATION
State: OH
PostalCode: 440289776
CountryCode: US
TelephoneNumber: 4402421466
FaxNumber:  
Practice Location
Address1: 1730 W 25TH ST
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441133108
CountryCode: US
TelephoneNumber: 2166964300
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/23/2022
LastUpdateDate: 04/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0200XRN.429741OHY Nursing Service ProvidersRegistered NurseCritical Care Medicine

No ID Information.


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