Healthcare Provider Details

I. General information

NPI: 1861225849
Provider Name (Legal Business Name): RACHEL A HERMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 SOUTHERN BLVD
KETTERING OH
45429-1221
US

IV. Provider business mailing address

3460 HANSON RD
SPRINGFIELD OH
45504-4322
US

V. Phone/Fax

Practice location:
  • Phone: 937-294-3611
  • Fax: 937-294-9010
Mailing address:
  • Phone: 614-737-4172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008949RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: