Provider Demographics
NPI:1477076297
Name:DILLON, RACHEL ANN (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:DILLON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:BORREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15059 N SCOTTSDALE RD STE 600
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2685
Mailing Address - Country:US
Mailing Address - Phone:602-778-3601
Mailing Address - Fax:602-445-9390
Practice Address - Street 1:600 EAST BLVD
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2483
Practice Address - Country:US
Practice Address - Phone:574-294-2621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007273A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care