Provider Demographics
NPI:1235867615
Name:MCCAIN, RACHEL ANN (CAA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:FAIRCLOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13340 OCEAN MIST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5204
Mailing Address - Country:US
Mailing Address - Phone:190-465-7779
Mailing Address - Fax:
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8211
Practice Address - Country:US
Practice Address - Phone:904-202-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant