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NPI 1578745519

NPI 1578745519 : RACHEL J CERCHIA PA : COLORADO SPRINGS, CO

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General NPI Number Information
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    NPI Number           |    1578745519
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL J CERCHIA PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/01/2007
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    Last Update Date     |    12/29/2016
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Provider Practice Location Address
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    Address Line         |    3010 N CIRCLE DR STE 100
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80909-1182
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    Country              |    US
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    Telephone            |    719-473-3332
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    Fax                  |    719-570-9030
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Provider Business Mailing Address
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    Address Line         |    3010 N CIRCLE DR STE 100
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80909-1182
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    Country              |    US
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    Telephone            |    719-473-3332
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    Fax                  |    719-570-9030
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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        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    2535
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    License Number State |    CO
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