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NPI Code Detail

MEDICARE: MRS. RACHEL LYNN BLASINGAME APRN, FNP-C

MEDICARE: MRS. RACHEL LYNN BLASINGAME APRN, FNP-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
1207RC0000XCardiovascular Disease Physician270989AZ
2363LF0000XFamily Nurse Practitioner270989AZ

General Provider Information

NPI Number : 1326791005
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHEL LYNN BLASINGAME APRN, FNP-C
Provider Business Mailing Address
First Line : 5465 S PRIMAVERA DR
Second Line :
City : FORT MOHAVE
State : AZ
Zip : 86426-8000
Country : US
Telephone Number : 702-569-2636
Fax Number :
Provider Business Practice Location Address
First Line : 1648 HIGHWAY 95
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-7906
Country : US
Telephone Number : 928-758-4114
Fax Number : 928-758-4650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2022
Last Update Date : 01/13/2026

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