Provider Demographics
NPI:1548920309
Name:LASSITER, RAHEL R (CPM)
Entity type:Individual
Prefix:
First Name:RAHEL
Middle Name:R
Last Name:LASSITER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 CRANWELL CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-7868
Mailing Address - Country:US
Mailing Address - Phone:336-404-4933
Mailing Address - Fax:
Practice Address - Street 1:3808 CRANWELL CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-7868
Practice Address - Country:US
Practice Address - Phone:336-404-4933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000139176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife