MEDICARE: MISS RANI PATEL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	8479	AZ
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1023536893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RANI PATEL PA-C

Provider Business Mailing Address
First Line	:	2519 MEADOWMIST PL SE
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-6314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8222 S 48TH ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-5303
Country	:	US
Telephone Number	:	623-300-5477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	10/06/2025

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Directions to “ MISS RANI PATEL PA-C” Practice Location

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