Provider Demographics
NPI:1225624083
Name:RAWLINGS, MECHELLE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:MECHELLE
Middle Name:LYNN
Last Name:RAWLINGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12995 N MARSHALL RANCH DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1966
Mailing Address - Country:US
Mailing Address - Phone:623-486-6453
Mailing Address - Fax:623-486-6461
Practice Address - Street 1:12995 N MARSHALL RANCH DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1966
Practice Address - Country:US
Practice Address - Phone:623-486-6453
Practice Address - Fax:623-486-6461
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP054906164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse