Provider Demographics
NPI:1437403441
Name:NUTTING, RACHEL ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:NUTTING
Suffix:
Gender:F
Credentials:PA-C
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 277976
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1906 FAIRVIEW AVE STE 230
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5432
Practice Address - Country:US
Practice Address - Phone:208-459-4667
Practice Address - Fax:208-459-3372
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-1019363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical