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General NPI Number Information
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NPI Number | 1003524679
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Entity Type | Individual
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Provider Name | RACHELLY DE LA CRUZ RN
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1642 S PRIEST DR BLDG 6
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City | TEMPE
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State | AZ
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Zip | 85281-6204
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Country | US
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Telephone | 602-685-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 N CENTRAL AVE STE 400
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City | PHOENIX
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State | AZ
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Zip | 85012-2929
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Country | US
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Telephone | 602-685-6000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 328855
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2371836
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN78352
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License Number State | RI
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