Provider Demographics
NPI:1326630377
Name:THOMASSON, RACHELLE GIOVANNA MCCAULEY (AGNP)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:GIOVANNA MCCAULEY
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:MCCAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10207 CERNY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4880
Mailing Address - Country:US
Mailing Address - Phone:919-405-2341
Mailing Address - Fax:
Practice Address - Street 1:10207 CERNY ST STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4880
Practice Address - Country:US
Practice Address - Phone:919-405-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC288541163WG0100X
NC5014571363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology