Provider Demographics
NPI:1285173278
Name:BARTHELEMY, RACHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:BARTHELEMY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 10TH AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:304-691-8722
Mailing Address - Fax:
Practice Address - Street 1:659 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1313
Practice Address - Country:US
Practice Address - Phone:304-736-5247
Practice Address - Fax:304-736-7367
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9313817363L00000X, 363LF0000X
WV110212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020428700Medicaid