Provider Demographics
NPI:1821574013
Name:STANLEY, RACHEL LEAH (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEAH
Last Name:STANLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1088
Mailing Address - Country:US
Mailing Address - Phone:903-223-9911
Mailing Address - Fax:
Practice Address - Street 1:4401 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1088
Practice Address - Country:US
Practice Address - Phone:903-223-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily