MEDICARE: RACHAEL OLIVIA PUSZCZYNSKI FNP

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	363L00000X	Nurse Practitioner	5023548	NC
2	363L00000X	Nurse Practitioner	299620	NC
3	2080P0207X	Pediatric Hematology & Oncology Physician	SP024873	PA

General Provider Information

NPI Number	:	1710644158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL OLIVIA PUSZCZYNSKI FNP

Provider Business Mailing Address
First Line	:	2400 PRATT ST STE 3400
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-3976
Country	:	US
Telephone Number	:	919-684-8964
Fax Number	:	919-613-5159

Provider Business Practice Location Address
First Line	:	2400 PRATT ST STE 3400
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-3976
Country	:	US
Telephone Number	:	919-684-8964
Fax Number	:	919-613-5159

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

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	03/04/2026

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