Healthcare Provider Details

I. General information

NPI: 1639080039
Provider Name (Legal Business Name): RACHEL KURCON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7164 YOUNGSTOWN PITTSBURGH RD
YOUNGSTOWN OH
44514-2511
US

IV. Provider business mailing address

7164 YOUNGSTOWN PITTSBURGH RD
YOUNGSTOWN OH
44514-2511
US

V. Phone/Fax

Practice location:
  • Phone: 330-559-1542
  • Fax:
Mailing address:
  • Phone: 330-559-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: