Provider Demographics
NPI:1467118885
Name:MARKHAM, RACHEL OLIVIA
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:OLIVIA
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:OLIVIA
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 CABARRUS AVE E STE 200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3781
Mailing Address - Country:US
Mailing Address - Phone:919-932-5700
Mailing Address - Fax:919-933-6881
Practice Address - Street 1:101 CABARRUS AVE E STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3781
Practice Address - Country:US
Practice Address - Phone:919-932-5700
Practice Address - Fax:919-933-6881
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12097363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-12097OtherNORTH CAROLINA MEDICAL BOARD