Provider Demographics
NPI:1952584583
Name:TROTTER, ANGELA RHAE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RHAE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:RHAE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:322 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-2358
Mailing Address - Country:US
Mailing Address - Phone:254-836-0094
Mailing Address - Fax:254-836-1008
Practice Address - Street 1:331 RED OAK CIR
Practice Address - Street 2:
Practice Address - City:CHINA SPRING
Practice Address - State:TX
Practice Address - Zip Code:76633-2765
Practice Address - Country:US
Practice Address - Phone:254-836-0094
Practice Address - Fax:254-836-1008
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215689501Medicaid