Provider Demographics
NPI:1467415422
Name:BILLINGSLEY HENDERSON, RACHEL DENISE (APN, FNP-BC, DNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENISE
Last Name:BILLINGSLEY HENDERSON
Suffix:
Gender:F
Credentials:APN, FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9073
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6923
Mailing Address - Country:US
Mailing Address - Phone:615-566-9992
Mailing Address - Fax:615-622-8768
Practice Address - Street 1:1067 RIVERFRONT PKWY STE 201
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2222
Practice Address - Country:US
Practice Address - Phone:855-571-4500
Practice Address - Fax:615-622-8768
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006909363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3343379Medicaid
TNP00292476OtherMEDICARE RAILROAD PIN
TNP00292476OtherMEDICARE RAILROAD PIN
TN3343379Medicare ID - Type UnspecifiedMEDICARE PROVIDER #