Provider Demographics
NPI:1871513887
Name:CHANEY, RACHEL K (M D,)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:K
Last Name:CHANEY
Suffix:
Gender:F
Credentials:M D,
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:K
Other - Last Name:CHANEY-ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6210
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-6210
Mailing Address - Country:US
Mailing Address - Phone:505-609-2258
Mailing Address - Fax:505-609-2259
Practice Address - Street 1:480 WOLVERINE DR
Practice Address - Street 2:UNIT 12
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-9653
Practice Address - Country:US
Practice Address - Phone:970-444-0260
Practice Address - Fax:970-444-0264
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM92-195207RC0000X
CODR.0052967207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV31119Medicare PIN
CAXPY190788Medicaid
NVNV3597OtherBLUE CROSS BLUE SHIELD
NV060049735Medicare PIN
NVF58960Medicare UPIN
NV002016540Medicaid