Healthcare Provider Details

I. General information

NPI: 1184975054
Provider Name (Legal Business Name): RACHEL ELISABETH ALLEN PATEL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 W EL CAMINO DR
PHOENIX AZ
85021-5543
US

IV. Provider business mailing address

917 W EL CAMINO DR
PHOENIX AZ
85021-5543
US

V. Phone/Fax

Practice location:
  • Phone: 402-980-3891
  • Fax:
Mailing address:
  • Phone: 140-298-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number257010
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA1084
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: