Provider Demographics
NPI:1902170855
Name:HOTVET, RACHEL R (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:R
Last Name:HOTVET
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:R
Other - Last Name:RYDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4950 S MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2708
Mailing Address - Country:US
Mailing Address - Phone:605-330-9619
Mailing Address - Fax:
Practice Address - Street 1:4950 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108
Practice Address - Country:US
Practice Address - Phone:605-330-9619
Practice Address - Fax:605-330-9503
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0811363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant