Provider Demographics
NPI:1629160072
Name:MCCANN, RACHEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:L
Last Name:MCCANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8401 W DODGE RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3451
Mailing Address - Country:US
Mailing Address - Phone:402-955-6877
Mailing Address - Fax:402-955-6880
Practice Address - Street 1:9801 GILES ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128
Practice Address - Country:US
Practice Address - Phone:402-955-8400
Practice Address - Fax:402-955-8401
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE22435208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025373200Medicaid
NE1157OtherBCBS