Provider Demographics
NPI:1508646738
Name:WHITE, RACHEL JANE (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2304 CLUTE RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-9531
Mailing Address - Country:US
Mailing Address - Phone:607-591-7917
Mailing Address - Fax:
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-446-5185
Practice Address - Fax:704-446-0221
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2024-02-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant