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NPI Code Detail

MEDICARE: RACHEL L. SULLIVAN PA-C

MEDICARE: RACHEL L. SULLIVAN PA-C
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
1363A00000XPhysician AssistantPA427ME

General Provider Information

NPI Number : 1851954218
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL L. SULLIVAN PA-C
Provider Business Mailing Address
First Line : 575 MAIN ST
Second Line :
City : GORHAM
State : ME
Zip : 04038-2623
Country : US
Telephone Number : 207-839-2559
Fax Number : 207-523-1135
Provider Business Practice Location Address
First Line : 575 MAIN ST
Second Line :
City : GORHAM
State : ME
Zip : 04038-2623
Country : US
Telephone Number : 207-839-2559
Fax Number : 207-523-1135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2019
Last Update Date : 02/09/2026

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Directions to “ RACHEL L. SULLIVAN PA-C” Practice Location

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