Basic Information
| Provider Information | |||||||||
| NPI: | 1437752086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOLDSBOROUGH | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPADIN | ||||||||
| OtherFirstName: | RACHEL | ||||||||
| OtherMiddleName: | LYNN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7055 BOGGS SCHOOLHOUSE RD | ||||||||
| Address2: | |||||||||
| City: | WESTOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218713739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4439444832 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 200 E VINE ST STE B | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218045531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4433586445 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2020 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R223111 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.