Individual
RACHEL LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4700 WATERS AVE FL 1, SAVANNAH, GA 31404-6220
(912) 350-8712
(912) 350-8753
Mailing address
4700 WATERS AVE FL 1, SAVANNAH, GA 31404-6220
(912) 354-8712
(912) 350-8753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003111026A
—
GA
05
—
1212PA
—
SC
01
—
624817
WELLCARE
GA
01
—
P00955091
RAILROAD MEDICARE
GA
Enumeration date
06/16/2011
Last updated
01/04/2022
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