Healthcare Provider Details

I. General information

NPI: 1245487768
Provider Name (Legal Business Name): RACHEL ELIZABETH ROKSER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 UNIVERSITY AVE
DUBUQUE IA
52001-5050
US

IV. Provider business mailing address

624 N BROADWAY STE 117
BALTIMORE MD
21205-1900
US

V. Phone/Fax

Practice location:
  • Phone: 563-589-3000
  • Fax:
Mailing address:
  • Phone: 410-614-4373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberCO3838
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number107256
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: