Provider Demographics
NPI:1134764590
Name:BENNETT, RACHAEL (FNP-C)
Entity type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 E BELL RD STE 4500
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2171
Mailing Address - Country:US
Mailing Address - Phone:602-633-3838
Mailing Address - Fax:
Practice Address - Street 1:14001 N 7TH ST STE F111
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4382
Practice Address - Country:US
Practice Address - Phone:602-633-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ231199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner