Provider Demographics
NPI:1902580913
Name:MARTINEZ, RACHEL PATRICE (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:PATRICE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7500 N DREAMY DRAW DR STE 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4668
Mailing Address - Country:US
Mailing Address - Phone:480-882-4545
Mailing Address - Fax:602-409-0499
Practice Address - Street 1:11851 N 51ST AVE STE F140
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-2847
Practice Address - Country:US
Practice Address - Phone:480-882-4545
Practice Address - Fax:623-242-1314
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ292694363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ137980Medicaid