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General NPI Number Information
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NPI Number | 1487935888
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Entity Type | Individual
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Provider Name | RACHEL MILNER MELLICK PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 3651 WHEELER RD MOB I SUITE 205
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City | AUGUSTA
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State | GA
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Zip | 30909-6521
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Country | US
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Telephone | 706-651-2369
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Fax |
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Provider Business Mailing Address
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Address Line | 4439 PIERWOOD WAY
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City | EVANS
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State | GA
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Zip | 30809-4503
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Country | US
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Telephone | 770-355-5999
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6264
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License Number State | GA
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