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General NPI Number Information
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NPI Number | 1043656291
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Entity Type | Individual
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Provider Name | RACHEL MEADOR BENNETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 57 OFFICE PARK DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7327
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Country | US
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Telephone | 910-353-4414
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Fax | 910-353-2972
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Provider Business Mailing Address
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Address Line | 2111 NEUSE BLVD STE J
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City | NEW BERN
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State | NC
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Zip | 28560-4318
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Country | US
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Telephone | 252-636-0300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-04222
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License Number State | NC
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