Provider Demographics
NPI:1528148343
Name:BREGANT, RACHELL HART (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:RACHELL
Middle Name:HART
Last Name:BREGANT
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:RACHELL
Other - Middle Name:DIANO
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:1051 TRADEWINDS RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4404
Mailing Address - Country:US
Mailing Address - Phone:757-685-4599
Mailing Address - Fax:
Practice Address - Street 1:1464 MOUNT PLEASANT RD
Practice Address - Street 2:SUITES 13 AND 14
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4043
Practice Address - Country:US
Practice Address - Phone:757-410-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001823363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant