Provider Demographics
NPI:1013654193
Name:FRIEDRICHS, RACHEL MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:FRIEDRICHS
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 1:28300 W 37TH ST N
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:KS
Mailing Address - Zip Code:67108-9301
Mailing Address - Country:US
Mailing Address - Phone:316-789-4575
Mailing Address - Fax:
Practice Address - Street 1:28300 W 37TH ST N
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:KS
Practice Address - Zip Code:67108-9301
Practice Address - Country:US
Practice Address - Phone:316-789-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS02672363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant