Provider Demographics
NPI:1083488308
Name:GALVAN, RACQUEL PILAR (FNP-C)
Entity type:Individual
Prefix:
First Name:RACQUEL
Middle Name:PILAR
Last Name:GALVAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4135 S POWER RD STE 129
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-3627
Mailing Address - Country:US
Mailing Address - Phone:480-751-3091
Mailing Address - Fax:480-751-3095
Practice Address - Street 1:4135 S POWER RD STE 129
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-3627
Practice Address - Country:US
Practice Address - Phone:480-751-3091
Practice Address - Fax:480-751-3095
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ299837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily