Basic Information
| Provider Information | |||||||||
| NPI: | 1346632999 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LASHUA | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | THOMPSON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STANLEY | ||||||||
| OtherFirstName: | RACHAEL | ||||||||
| OtherMiddleName: | THOMPSON | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 29 NORTHWEST BLVD | ||||||||
| Address2: | IMMEDIATE CARE OF SOUTHERN NH | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030634068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035772273 | ||||||||
| FaxNumber: | 6035775191 | ||||||||
| Practice Location | |||||||||
| Address1: | 29 NORTHWEST BLVD | ||||||||
| Address2: | IMMEDIATE CARE OF SOUTHERN NH | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030634068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035772273 | ||||||||
| FaxNumber: | 6035775191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2015 | ||||||||
| LastUpdateDate: | 02/19/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 1069 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.