Provider Demographics
NPI:1972474203
Name:CACTUS WREN HEALTH COLLECTIVE LLC
Entity type:Organization
Organization Name:CACTUS WREN HEALTH COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:RAELYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WIEST
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:510-809-6331
Mailing Address - Street 1:738 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-8478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-8331
Practice Address - Country:US
Practice Address - Phone:510-809-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty