Provider Demographics
NPI:1073837886
Name:ARMSTRONG, RACHEL DENISE (CPNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENISE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E MAIN ST STE D100
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-4644
Mailing Address - Country:US
Mailing Address - Phone:928-474-9399
Mailing Address - Fax:928-474-9399
Practice Address - Street 1:117 E MAIN ST STE D100
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4644
Practice Address - Country:US
Practice Address - Phone:928-474-9399
Practice Address - Fax:928-474-9831
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3550363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ085306Medicaid