Provider Demographics
NPI:1578610572
Name:PACHECO-BAX, RHITA (FNP)
Entity Type:Individual
Prefix:
First Name:RHITA
Middle Name:
Last Name:PACHECO-BAX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RHITA
Other - Middle Name:
Other - Last Name:PACHECO-BAX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:9900 BREN RD E
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14875 IRVING ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-9409
Practice Address - Country:US
Practice Address - Phone:303-718-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily