Provider Demographics
NPI:1821200452
Name:EVANS, RACHEL H (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:H
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16248 E POWDERHORN DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6527
Mailing Address - Country:US
Mailing Address - Phone:480-816-5932
Mailing Address - Fax:
Practice Address - Street 1:16248 E POWDERHORN DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6527
Practice Address - Country:US
Practice Address - Phone:480-816-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1115101OtherCIGNA PROVIDER NUMBER
AZ13619OtherSTATE LICENSE NUMBER
AZAE2599617OtherDEA NUMBER
AZAE2599617OtherDEA NUMBER
AZZ22342Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER