Provider Demographics
NPI:1548947021
Name:HARRIS, RACHEL NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:HARRIS
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 1:3241 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4850
Mailing Address - Country:US
Mailing Address - Phone:774-991-2904
Mailing Address - Fax:
Practice Address - Street 1:3241 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4850
Practice Address - Country:US
Practice Address - Phone:203-383-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant