Provider Demographics
NPI:1558134130
Name:BARKSDALE, RACHEL JANNELL (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANNELL
Last Name:BARKSDALE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:601-200-4370
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:971 LAKELAND DR STE 360
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4607
Practice Address - Country:US
Practice Address - Phone:601-200-4370
Practice Address - Fax:601-200-4375
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS905252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner