Basic Information
| Provider Information | |||||||||
| NPI: | 1134403751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALSOP | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | LEIGHANNE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RD LD PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BELEW | ||||||||
| OtherFirstName: | RACHEL | ||||||||
| OtherMiddleName: | LEIGHANNE | ||||||||
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| OtherCredential: | RD LD PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1364 CLIFTON RD NE | ||||||||
| Address2: | CENTER FOR CRITICAL CARE MEDICINE | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047122000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1364 CLIFTON RD NE | ||||||||
| Address2: | CENTER FOR CRITICAL CARE MEDICINE | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047122000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2011 | ||||||||
| LastUpdateDate: | 02/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 7906 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 133V00000X | L003763 | NC | N | Dietary & Nutritional Service Providers | Dietitian, Registered | 133V00000X | LD002801 | GA | N | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.