Basic Information
| Provider Information | |||||||||
| NPI: | 1760112676 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | ADRIEL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPAS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 BLUE JAY WAY | ||||||||
| Address2: | |||||||||
| City: | STELLA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285829687 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615371056 | ||||||||
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| Practice Location | |||||||||
| Address1: | 225 WHITE ST | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285466351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103537222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 0010-11955 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.