Provider Demographics
NPI:1710392634
Name:SEVERE, RACHEL KATHERINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:KATHERINE
Last Name:SEVERE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1130 MEDICAL PL
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2640
Mailing Address - Country:US
Mailing Address - Phone:812-519-1552
Mailing Address - Fax:812-519-1774
Practice Address - Street 1:1130 MEDICAL PL
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2640
Practice Address - Country:US
Practice Address - Phone:812-519-1552
Practice Address - Fax:812-519-1774
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10001855A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant