Provider Demographics
NPI:1295371698
Name:GOLDSON, RACHEL N (MPAS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:GOLDSON
Suffix:
Gender:F
Credentials:MPAS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:N
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPAS
Mailing Address - Street 1:8300 GOLDEN VALLEY RD APT 228
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4455
Mailing Address - Country:US
Mailing Address - Phone:612-991-8961
Mailing Address - Fax:
Practice Address - Street 1:420 DELAWARE STREET SE
Practice Address - Street 2:MMC 480
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0392
Practice Address - Country:US
Practice Address - Phone:612-624-0123
Practice Address - Fax:612-625-6919
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13072363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant