Healthcare Provider Details

I. General information

NPI: 1326791005
Provider Name (Legal Business Name): RACHEL LYNN BLASINGAME APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1648 HIGHWAY 95
BULLHEAD CITY AZ
86442-7906
US

IV. Provider business mailing address

5465 S PRIMAVERA DR
FORT MOHAVE AZ
86426-8000
US

V. Phone/Fax

Practice location:
  • Phone: 928-758-4114
  • Fax: 928-758-4650
Mailing address:
  • Phone: 702-569-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number270989
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number270989
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: