Healthcare Provider Details

I. General information

NPI: 1992435515
Provider Name (Legal Business Name): RACHEL LYNN WEST PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL LYNN KIKER PA-C

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 12/26/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 S HORNER BLVD
SANFORD NC
27332-8037
US

IV. Provider business mailing address

PO BOX 187
FAISON NC
28341-0187
US

V. Phone/Fax

Practice location:
  • Phone: 984-251-1331
  • Fax: 984-201-1163
Mailing address:
  • Phone: 910-267-2057
  • Fax: 855-996-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12341
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: