Provider Demographics
NPI:1043816689
Name:GOLDSTEIN, RACHEL MELISSA (CRNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MELISSA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 KIPLING RD
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3340
Mailing Address - Country:US
Mailing Address - Phone:215-840-1402
Mailing Address - Fax:
Practice Address - Street 1:918 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2502
Practice Address - Country:US
Practice Address - Phone:610-525-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022509363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health