Provider Demographics
NPI:1477950798
Name:STEPHENSON, RACHEL SUE (NP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:SUE
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:888 TARA BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7818
Mailing Address - Country:US
Mailing Address - Phone:225-273-5995
Mailing Address - Fax:
Practice Address - Street 1:888 TARA BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7818
Practice Address - Country:US
Practice Address - Phone:225-273-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07750363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics