Healthcare Provider Details

I. General information

NPI: 1831235464
Provider Name (Legal Business Name): RACHAEL ANASTASIA MCGRAW CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 WESTCHESTER DR
SAINT PAUL MN
55118-2512
US

IV. Provider business mailing address

141 WESTCHESTER DR
SAINT PAUL MN
55118-2512
US

V. Phone/Fax

Practice location:
  • Phone: 651-983-7522
  • Fax: 651-291-2605
Mailing address:
  • Phone: 651-983-7522
  • Fax: 651-291-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1012
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: