Healthcare Provider Details

I. General information

NPI: 1023536893
Provider Name (Legal Business Name): RANI PATEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 S 48TH ST STE 200
PHOENIX AZ
85044-5303
US

IV. Provider business mailing address

2519 MEADOWMIST PL SE
CONYERS GA
30013-6314
US

V. Phone/Fax

Practice location:
  • Phone: 623-300-5477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number8479
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: