Healthcare Provider Details

I. General information

NPI: 1730656034
Provider Name (Legal Business Name): RACHEL MATTIX PATEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 N 64TH DR STE 220
GLENDALE AZ
85308-7109
US

IV. Provider business mailing address

18700 N 64TH DR STE 220
GLENDALE AZ
85308-7109
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-5437
  • Fax:
Mailing address:
  • Phone: 602-277-6211
  • Fax: 602-277-1074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number290244
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: