| Doctor Name: | MRS. RICHELLE MARIE ROETHLER |
| NPI Number: | 1457785859 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.P.N. |
| License Number: | A107678 |
| Business Practice Address: | 1314 10th St Ste B Silvis, IL - 612821892 |
| Business Phone Number: | 3092812420 |
| Business Fax Number: | 3092812429 |
| Mailing Address: | 5964 Dodds Dr, BETTENDORF |
| State: | IA |
| Postal Code: | 527226541 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2013 |
| NPI Last Update Date: | 12/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A107678 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |