Provider Demographics
NPI:1326791005
Name:BLASINGAME, RACHEL LYNN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNN
Last Name:BLASINGAME
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:5465 S PRIMAVERA DR
Mailing Address - Street 2:
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-8000
Mailing Address - Country:US
Mailing Address - Phone:702-569-2636
Mailing Address - Fax:
Practice Address - Street 1:5717 HWY 95 STE 4
Practice Address - Street 2:
Practice Address - City:FORT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-6050
Practice Address - Country:US
Practice Address - Phone:928-577-2727
Practice Address - Fax:888-498-4639
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ270989363LF0000X
NV832998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily