Provider Demographics
NPI:1316171853
Name:RAHER, JODI J (PA-C)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:J
Last Name:RAHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 NORTH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3845
Mailing Address - Country:US
Mailing Address - Phone:508-778-4888
Mailing Address - Fax:
Practice Address - Street 1:46 NORTH ST STE 6
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3845
Practice Address - Country:US
Practice Address - Phone:508-778-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant