Healthcare Provider Details

I. General information

NPI: 1447182001
Provider Name (Legal Business Name): RACHEL WALDVOGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 WALKER AVE
GREENSBORO NC
27403
US

IV. Provider business mailing address

4235 CHIPPENHAM CT
GRAHAM NC
27253-8017
US

V. Phone/Fax

Practice location:
  • Phone: 336-334-5400
  • Fax:
Mailing address:
  • Phone: 516-297-4438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number372248
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: