MEDICARE: RACHEL ELIZABETH FEDORNOCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063345676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ELIZABETH FEDORNOCK

Provider Business Mailing Address
First Line	:	204 ANTHONY ST
Second Line	:
City	:	HARRISON CITY
State	:	PA
Zip	:	15636-1224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 ANTHONY ST
Second Line	:
City	:	HARRISON CITY
State	:	PA
Zip	:	15636-1224
Country	:	US
Telephone Number	:	814-871-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ RACHEL ELIZABETH FEDORNOCK ” Practice Location

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