Provider Demographics
NPI:1629098165
Name:WUNSCH, RACHEAL (RN, FNP-C, ACHPN)
Entity Type:Individual
Prefix:MRS
First Name:RACHEAL
Middle Name:
Last Name:WUNSCH
Suffix:
Gender:F
Credentials:RN, FNP-C, ACHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ARABIAN DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3248
Mailing Address - Country:US
Mailing Address - Phone:361-580-1650
Mailing Address - Fax:
Practice Address - Street 1:605 E LOCUST AVE
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3933
Practice Address - Country:US
Practice Address - Phone:361-572-4300
Practice Address - Fax:361-570-0908
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202548801Medicaid
TX818N56OtherBLUE CROSS BLUE SHIELD
TX8K3643Medicare PIN