Healthcare Provider Details

I. General information

NPI: 1881857472
Provider Name (Legal Business Name): RACHAEL LOUISE HUEFTLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10791 DOUBLE R BLVD
RENO NV
89521-8956
US

IV. Provider business mailing address

3905 WARING RD
OCEANSIDE CA
92056-4405
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-6100
  • Fax:
Mailing address:
  • Phone: 760-724-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number21803
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN001062
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: