Provider Demographics
NPI:1083372296
Name:PEARSON, RAKELIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:RAKELIA
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 WINSLOW ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-5811
Mailing Address - Country:US
Mailing Address - Phone:478-731-8226
Mailing Address - Fax:
Practice Address - Street 1:838 WINSLOW ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-5811
Practice Address - Country:US
Practice Address - Phone:478-731-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN257121163WH0200X, 163WM0102X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn