Provider Demographics
NPI:1235310145
Name:YATES, RACHEL LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LYNN
Last Name:YATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9085 E MINERAL CIR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3462
Mailing Address - Country:US
Mailing Address - Phone:303-801-0129
Mailing Address - Fax:303-586-8206
Practice Address - Street 1:2030 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3178
Practice Address - Country:US
Practice Address - Phone:303-951-4059
Practice Address - Fax:303-951-4060
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98805207Q00000X
CO46590207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO022777OtherKAISER COMMERCIAL NUMBER
CO25287214Medicaid
CO022777OtherKAISER COMMERCIAL NUMBER