Provider Demographics
NPI:1467348037
Name:STOTTLEMYRE, RACHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:STOTTLEMYRE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:
Other - Last Name:WILBUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9016 COURTENAY ST APT 5105
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-0923
Mailing Address - Country:US
Mailing Address - Phone:912-484-2771
Mailing Address - Fax:
Practice Address - Street 1:1620 FM 3344
Practice Address - Street 2:
Practice Address - City:JACKSBORO
Practice Address - State:TX
Practice Address - Zip Code:76458-3127
Practice Address - Country:US
Practice Address - Phone:940-567-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily