Provider Demographics
NPI:1710173927
Name:RHEINGANS, MERRIE J
Entity Type:Individual
Prefix:
First Name:MERRIE
Middle Name:J
Last Name:RHEINGANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERRIE
Other - Middle Name:J
Other - Last Name:MCCOLLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:C-PNP
Mailing Address - Street 1:2175 N ALMA SCHOOL RD
Mailing Address - Street 2:C-104
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2878
Mailing Address - Country:US
Mailing Address - Phone:480-298-9761
Mailing Address - Fax:
Practice Address - Street 1:2175 N ALMA SCHOOL RD
Practice Address - Street 2:C-104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2878
Practice Address - Country:US
Practice Address - Phone:480-298-9761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP2862363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics