Provider Demographics
NPI:1083421077
Name:TROTTER, RAQUEL ANNE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:ANNE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:ANNE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12806 E GIADA DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-0585
Mailing Address - Country:US
Mailing Address - Phone:520-409-5020
Mailing Address - Fax:
Practice Address - Street 1:12806 E GIADA DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-0585
Practice Address - Country:US
Practice Address - Phone:520-409-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF12240190363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology