Healthcare Provider Details

I. General information

NPI: 1265320576
Provider Name (Legal Business Name): RACHAEL MAXWELL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 BUFORD HWY STE 300
NORCROSS GA
30071-2504
US

IV. Provider business mailing address

6304 BROOMSEDGE TRL
PEACHTREE CORNERS GA
30092-1810
US

V. Phone/Fax

Practice location:
  • Phone: 678-993-0820
  • Fax:
Mailing address:
  • Phone: 770-363-9653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: