Provider Demographics
NPI:1659728699
Name:BAUMANN, RACHEL D (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:BAUMANN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:D
Other - Last Name:HELMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:110 KINGSLEY LN STE 305
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4617
Mailing Address - Country:US
Mailing Address - Phone:757-889-5422
Mailing Address - Fax:
Practice Address - Street 1:110 KINGSLEY LN STE 305
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4617
Practice Address - Country:US
Practice Address - Phone:757-889-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110005384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10170220POtherOPTIMA HEALTH
VA1659728699OtherHUMANA
VA599608OtherBLUE CROSS BLUE SHIELD MEDICARE SUPPLEMENT
VA1659728699Medicaid