Rakebrand, Athena

Rakebrand, Athena is an individual health care provider with primary practice located at 705 Griffith St Ste 301 , Davidson NC 28036-9308. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Rakebrand, Athena can be contacted via phone (704) 237-4240.

Contact Information

Primary practice address
705 Griffith St Ste 301 Davidson NC 28036-9308
Phone: (704) 237-4240
Fax: (704) 785-8304
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4606 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 001012879 North Carolina

Profile Details

NPI number 1528619111
LBN Legal business name Rakebrand, Athena
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2019
Last updated Mar 21st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528619111 NPPES
North Carolina Other 001012879 NC LICENSE
North Carolina Other PA202542 NC LICENSE
North Carolina Other 4606 NC LICENSE

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