Doctor Name: | RACHEL B PRANGER |
NPI Number: | 1336297860 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 2003016368-MO |
Business Practice Address: | 1115 Morgan St Suite 2 Carlinville, IL - 626261430 |
Business Phone Number: | 2178543881 |
Business Fax Number: | 2178543894 |
Mailing Address: | 1115 Morgan St, Suite 2 CARLINVILLE |
State: | IL |
Postal Code: | 626261430 |
Phone Number: | 2178543881 |
Fax Number: | 2178543894 |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 08/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 2003016368-MO |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |