Provider Demographics
NPI:1255662177
Name:MYERS, RACHEL JANE (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:MYERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S CATON AVE
Mailing Address - Street 2:MAILSTOP 134
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5201
Mailing Address - Country:US
Mailing Address - Phone:410-368-2000
Mailing Address - Fax:410-368-2009
Practice Address - Street 1:900 S CATON AVE
Practice Address - Street 2:MAILSTOP 134
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-2000
Practice Address - Fax:410-368-2009
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC04114363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical