MEDICARE: RACHAEL COLLEY PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	228182	AZ

General Provider Information

NPI Number	:	1689566945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL COLLEY PMHNP

Provider Business Mailing Address
First Line	:	5227 N 7TH ST STE 18083
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2802
Country	:	US
Telephone Number	:	520-201-3731
Fax Number	:	520-779-8890

Provider Business Practice Location Address
First Line	:	5227 N 7TH ST STE 18083
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2802
Country	:	US
Telephone Number	:	520-201-3731
Fax Number	:	520-779-8890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2025
Last Update Date	:	12/15/2025

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