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NPI Code Detail

MEDICARE: MS. RACHAEL ELLEN CALLAHAN PA-C

MEDICARE: MS. RACHAEL ELLEN CALLAHAN 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 Assistant2735-23WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992097315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHAEL ELLEN CALLAHAN PA-C
Provider Business Mailing Address
First Line : 3 NEENAH CTR
Second Line :
City : NEENAH
State : WI
Zip : 54956-3070
Country : US
Telephone Number : 920-702-6315
Fax Number : 920-993-5046
Provider Business Practice Location Address
First Line : 333 N GREEN BAY RD
Second Line :
City : NEENAH
State : WI
Zip : 54956-1954
Country : US
Telephone Number : 920-702-6315
Fax Number : 920-993-5046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2011
Last Update Date : 04/21/2026

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