Provider Demographics
NPI:1568993491
Name:WENGER, RACHEL ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:WENGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5360 LINCOLN HWY
Mailing Address - Street 2:SUITE 15
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9451
Mailing Address - Country:US
Mailing Address - Phone:717-442-8111
Mailing Address - Fax:717-442-8981
Practice Address - Street 1:5360 LINCOLN HWY
Practice Address - Street 2:SUITE 15
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9451
Practice Address - Country:US
Practice Address - Phone:717-442-8111
Practice Address - Fax:717-442-8981
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily