Provider Demographics
NPI:1801287354
Name:ARMENTA, RACHEL (ACNP RNFA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ARMENTA
Suffix:
Gender:F
Credentials:ACNP RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10930 N TATUM BLVD #103
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6069
Mailing Address - Country:US
Mailing Address - Phone:602-263-7600
Mailing Address - Fax:602-489-5276
Practice Address - Street 1:10930 N TATUM BLVD
Practice Address - Street 2:STE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6069
Practice Address - Country:US
Practice Address - Phone:602-263-7300
Practice Address - Fax:602-212-0365
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7395363LA2100X
AZ0000163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ001661Medicaid