Provider Demographics
NPI:1174753891
Name:MACKEY, RACHELLE LYNETTE (APRN)
Entity type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:LYNETTE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1207
Mailing Address - Country:US
Mailing Address - Phone:405-271-9663
Mailing Address - Fax:405-271-1728
Practice Address - Street 1:1000 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1207
Practice Address - Country:US
Practice Address - Phone:405-271-9663
Practice Address - Fax:405-271-1728
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR55843363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology