Provider Demographics
NPI:1083421077
Name:TROTTER, RAQUEL ANNE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:ANNE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:ANNE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 N GRAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-1061
Mailing Address - Country:US
Mailing Address - Phone:520-761-2128
Mailing Address - Fax:520-281-1112
Practice Address - Street 1:1209 W TARGET RANGE RD
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-2466
Practice Address - Country:US
Practice Address - Phone:520-281-1550
Practice Address - Fax:520-281-4487
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF12240190363LX0001X
AZ317965363LX0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology