Provider Demographics
NPI:1790297265
Name:RUGLETIC, RACHAEL LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LEE
Last Name:RUGLETIC
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1030 NEW HOLLAND AVE BLDG 12A
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5690
Mailing Address - Country:US
Mailing Address - Phone:717-544-8144
Mailing Address - Fax:717-544-8140
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-8144
Practice Address - Fax:717-544-8140
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA059433363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical