Healthcare Provider Details

I. General information

NPI: 1801466354
Provider Name (Legal Business Name): TAYLOR RACHEL FEREK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR RACHEL HODELL

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 S ONEIDA ST
APPLETON WI
54915-1305
US

IV. Provider business mailing address

600 LEMONGRASS WAY
KAUKAUNA WI
54130-3084
US

V. Phone/Fax

Practice location:
  • Phone: 920-738-2000
  • Fax:
Mailing address:
  • Phone: 715-574-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: