Provider Demographics
NPI:1073777504
Name:RANKIN, RACHEL DAVIS (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DAVIS
Last Name:RANKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:TILFORD
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:121 CALLE DEL PRESIDENTE
Mailing Address - Street 2:
Mailing Address - City:BERNALILLO
Mailing Address - State:NM
Mailing Address - Zip Code:87004-6091
Mailing Address - Country:US
Mailing Address - Phone:505-867-2324
Mailing Address - Fax:505-867-3511
Practice Address - Street 1:121 CALLE DEL PRESIDENTE
Practice Address - Street 2:
Practice Address - City:BERNALILLO
Practice Address - State:NM
Practice Address - Zip Code:87004
Practice Address - Country:US
Practice Address - Phone:505-867-2324
Practice Address - Fax:505-867-3511
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48164207Q00000X
NMMD2014-0630207Q00000X
NE26165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1456016Medicare PIN
NE086470009Medicare PIN