Healthcare Provider Details

I. General information

NPI: 1073777504
Provider Name (Legal Business Name): RACHEL DAVIS RANKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL TILFORD DAVIS MD

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CALLE DEL PRESIDENTE
BERNALILLO NM
87004
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-867-2324
  • Fax: 505-867-3511
Mailing address:
  • Phone: 505-272-1476
  • Fax: 505-867-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48164
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26165
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2014-0630
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: