Provider Demographics
NPI:1588623326
Name:ROLLING, RACHAEL MCLAUGHLIN (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MCLAUGHLIN
Last Name:ROLLING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 LAKESHORE RDG
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-6956
Mailing Address - Country:US
Mailing Address - Phone:205-266-5040
Mailing Address - Fax:
Practice Address - Street 1:41676 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1412
Practice Address - Country:US
Practice Address - Phone:985-543-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200040363AM0700X
ALPA474363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07103253Medicaid
LA1332453Medicaid
LA432326YH3VMedicare PIN