Provider Demographics
NPI:1235974577
Name:SIVITS, RACHEL JEAN (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JEAN
Last Name:SIVITS
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 1:131 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-6015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 PLAZA DR
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-6015
Practice Address - Country:US
Practice Address - Phone:304-597-3706
Practice Address - Fax:304-597-3709
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0010081363A00000X
WV3101363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant