1336804038 NPI number — RACHEL RENEE WARREN APC

Table of content: RACHEL RENEE WARREN APC (NPI 1336804038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336804038 NPI number — RACHEL RENEE WARREN APC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARREN
Provider First Name:
RACHEL
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336804038
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1344 MORRIS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARAGON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30104-1403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
290 MERCHANTS SQ STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30132-0930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-335-5305
Provider Business Practice Location Address Fax Number:
678-550-1155
Provider Enumeration Date:
11/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  007326 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 007326 . This is a "LICENSE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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