Basic Information
| Provider Information | |||||||||
| NPI: | 1093743510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 SMOKE RANCH RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022330727 | ||||||||
| FaxNumber: | 7022334799 | ||||||||
| Practice Location | |||||||||
| Address1: | 7500 SMOKE RANCH RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022330727 | ||||||||
| FaxNumber: | 7022334799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 02/23/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA1223 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AM0700X | PA1223 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | K24407 | 01 | NV | PALMETTO GBA J1 | OTHER | 1093743510 | 05 | NV | MEDICAID |