Rackley, Emmerll

Rackley, Emmerll is an sole proprietor health care provider with primary practice located at 1741 Sycamore Ave 3508 Western Ave, Kingman AZ 86409-0927. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Rackley, Emmerll can be contacted via phone (928) 757-8111.

Contact Information

Primary practice address
1741 Sycamore Ave 3508 Western Ave Kingman AZ 86409-0927
Phone: (928) 757-8111
Fax: (928) 757-1199
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R184121 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP3654 Arizona

Profile Details

NPI number 1538346994
LBN Legal business name Rackley, Emmerll
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2008
Last updated Jun 2nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538346994 NPPES
Arizona MEDICAID 519975

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