Rachel Lorraine Staten, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Belden, MS
NPI 1124359229 · NPPES record last updated Mar 22, 2012
Key facts
- NPI
- 1124359229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R883957 (MS)
- Practice address
- 112 Grand Ole Oaks Dr
Apt # 2
Belden, MS 38826-7014 - Phone
- (662) 269-2105
- NPI assigned
- Jan 29, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R883957 | MS | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R883957 | MS | Yes |
Addresses
Primary practice location
112 Grand Ole Oaks Dr
Apt # 2
Belden, MS 38826-7014
Mailing address
112 Grand Ole Oaks Dr
Apt # 2
Belden, MS 38826-7014
Phone (662) 269-2105
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08855320 | Medicaid | MS |
Other providers in Belden, MS
- Redimeds Pharmacy, LLC
- Rosewood Residence LLC
- Rosewood Tupelo LLC
- Praylar R Shells
- Brian Christopher Smith
- The Legacy Haus
- Kristina Marie Thompson
- Trident Anesthesia LLC
- Carla Quinn Weaver
- Christopher Morris Weaver
All providers in Belden, MS · Psychiatric/Mental Health Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.