Provider Demographics
NPI:1093743510
Name:BOWERS, RACHEL C (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:BOWERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 SMOKE RANCH RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0324
Mailing Address - Country:US
Mailing Address - Phone:702-233-0727
Mailing Address - Fax:702-233-4799
Practice Address - Street 1:7500 SMOKE RANCH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0324
Practice Address - Country:US
Practice Address - Phone:702-233-0727
Practice Address - Fax:702-233-4799
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1223363AS0400X, 363AM0700X
PA1223363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1093743510Medicaid
NVK24407OtherPALMETTO GBA J1
NVQ61667Medicare UPIN
NVDR655WMedicare PIN