Provider Demographics
NPI:1578954244
Name:WEKESA, RACHEL
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WEKESA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S POTOMAC ST STE 110
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5433
Mailing Address - Country:US
Mailing Address - Phone:720-324-4777
Mailing Address - Fax:616-226-4814
Practice Address - Street 1:1550 S POTOMAC ST STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5433
Practice Address - Country:US
Practice Address - Phone:720-324-4777
Practice Address - Fax:616-226-4814
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991531-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0991531-NPOtherLICENSE
F1014436OtherAANP CERTIFICATION