Healthcare Provider Details

I. General information

NPI: 1134748551
Provider Name (Legal Business Name): RACHEL KELSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL WEIGEL

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9930 W INDIAN SCHOOL RD
PHOENIX AZ
85037-5902
US

IV. Provider business mailing address

1661 E CAMELBACK RD STE 200
PHOENIX AZ
85016-3913
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7558
  • Fax: 623-846-1674
Mailing address:
  • Phone: 623-231-3686
  • Fax: 602-559-5694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number73201
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: