MEDICARE: RACHEL ANNE LAUGHLIN

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	363A00000X	Physician Assistant	50.006248RX	OH

General Provider Information

NPI Number	:	1578119269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ANNE LAUGHLIN

Provider Business Mailing Address
First Line	:	1504 E 107TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1830
Country	:	US
Telephone Number	:	407-808-2248
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 E 107TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1830
Country	:	US
Telephone Number	:	407-808-2248
Fax Number	:

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

Provider Enumeration Date	:	08/18/2019
Last Update Date	:	01/08/2020

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Directions to “ RACHEL ANNE LAUGHLIN ” Practice Location

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