Provider Demographics
NPI:1669107942
Name:QUIRING, RACHEL ANNE (PA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:QUIRING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 S 62ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3558
Mailing Address - Country:US
Mailing Address - Phone:402-489-3834
Mailing Address - Fax:402-489-5049
Practice Address - Street 1:5625 S 62ND ST STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3558
Practice Address - Country:US
Practice Address - Phone:402-489-3834
Practice Address - Fax:402-489-5049
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2790363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47049487112Medicaid