Healthcare Provider Details

I. General information

NPI: 1619630811
Provider Name (Legal Business Name): ELIZABETH RENTSCHLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 N MAIN ST
FUQUAY VARINA NC
27526-8901
US

IV. Provider business mailing address

1418 N MAIN ST
FUQUAY VARINA NC
27526-8901
US

V. Phone/Fax

Practice location:
  • Phone: 919-552-1733
  • Fax: 919-552-1495
Mailing address:
  • Phone: 919-552-1733
  • Fax: 919-552-1495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16363
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10710
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: