Healthcare Provider Details

I. General information

NPI: 1871281659
Provider Name (Legal Business Name): RACHEL ANN PARYZEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL ANN SCHEFFERT

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49725 COUNTY 83
STAPLES MN
56479-5280
US

IV. Provider business mailing address

524 AQUA CIR
LINO LAKES MN
55014-2717
US

V. Phone/Fax

Practice location:
  • Phone: 218-894-1515
  • Fax:
Mailing address:
  • Phone: 402-314-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: