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General NPI Number Information
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NPI Number | 1275343980
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Entity Type | Individual
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Provider Name | RACHEL MEAD AGACNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 13555 W MCDOWELL RD STE 204
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City | GOODYEAR
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State | AZ
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Zip | 85395-2626
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Country | US
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Telephone | 623-292-2250
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Fax |
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Provider Business Mailing Address
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Address Line | 13208 N 55TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85304-1315
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Country | US
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Telephone | 660-238-9897
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2024071462
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License Number State | AZ
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