Provider Demographics
NPI:1639453806
Name:YARBROUGH, RACHAEL JULIET (CNM)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:JULIET
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MRS
Other - First Name:RACHAEL
Other - Middle Name:JULIET
Other - Last Name:THOMPSON /BROOKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:333 RIO DULCE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2359
Mailing Address - Country:US
Mailing Address - Phone:915-345-1712
Mailing Address - Fax:
Practice Address - Street 1:5200 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7709
Practice Address - Country:US
Practice Address - Phone:214-590-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX810243367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1639453806Medicaid