Provider Demographics
NPI:1184928426
Name:GARZA HAUKOOS, RACHEL ALEANA (NP-C)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ALEANA
Last Name:GARZA HAUKOOS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ALEANA
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4856 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5539
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:844-270-1824
Practice Address - Street 1:4856 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5539
Practice Address - Country:US
Practice Address - Phone:970-494-4200
Practice Address - Fax:844-270-1824
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0165168163W00000X
COAPN.0994512-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15739830Medicaid
CO21718OtherKAISER COMMERCIAL NUMBER
COCOAAA1479Medicare PIN