Healthcare Provider Details

I. General information

NPI: 1073156584
Provider Name (Legal Business Name): ROCHELLE MARIE HUNTSMAN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 FALLS CT STE 100
BOERNE TX
78006
US

IV. Provider business mailing address

2961 MOSSROCK
SAN ANTONIO TX
78230-5119
US

V. Phone/Fax

Practice location:
  • Phone: 830-249-3800
  • Fax: 830-249-0882
Mailing address:
  • Phone: 210-731-4800
  • Fax: 210-731-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP143313
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: