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Organization
HAVASU RAINBOW PEDIATRICS AND ASSOCIATES PLLC
Active
Organization
HAVASU RAINBOW PEDIATRICS AND ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY RENEE GOLDEN DNP (MEMBER MANAGER)
(317) 414-5202
Entity
Organization
Contact information
Practice address
150 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5735
(928) 540-5437
(928) 540-5438
Mailing address
150 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5735
(928) 540-5437
(928) 540-5438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363LP0200X
Pediatric Nurse Practitioner
Primary
—
NULL
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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