Provider Demographics
NPI:1073946562
Name:MUSICK, RAELYNN M (NP)
Entity Type:Individual
Prefix:
First Name:RAELYNN
Middle Name:M
Last Name:MUSICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RAELYNN
Other - Middle Name:M
Other - Last Name:CATRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:890 W ELLIOT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5102
Mailing Address - Country:US
Mailing Address - Phone:480-545-2787
Mailing Address - Fax:480-545-1434
Practice Address - Street 1:7850 N SILVERBELL RD
Practice Address - Street 2:SUITE 132
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8219
Practice Address - Country:US
Practice Address - Phone:520-407-5884
Practice Address - Fax:520-744-6556
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN082278163W00000X
AZAP5116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP5116OtherNP
AZRN082278OtherRN LICENSE