Provider Demographics
NPI:1114514247
Name:LUGO, RACHEL M (NP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:LUGO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:OPRIHORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6636 E BASELINE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4430
Mailing Address - Country:US
Mailing Address - Phone:480-912-6262
Mailing Address - Fax:480-912-6261
Practice Address - Street 1:6636 E BASELINE RD STE 100
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4430
Practice Address - Country:US
Practice Address - Phone:480-912-6262
Practice Address - Fax:480-912-6261
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251374363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care