Provider Demographics
NPI:1720461916
Name:HERSOM, RACHEL (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HERSOM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1200 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2355
Mailing Address - Country:US
Mailing Address - Phone:515-248-1447
Mailing Address - Fax:515-248-1440
Practice Address - Street 1:7555 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4620
Practice Address - Country:US
Practice Address - Phone:515-225-7201
Practice Address - Fax:515-225-9213
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2024-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA078995363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant