Provider Demographics
NPI:1871860072
Name:O'RILEY, RACQUEL F (DNP, APN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RACQUEL
Middle Name:F
Last Name:O'RILEY
Suffix:
Gender:F
Credentials:DNP, APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S WALL ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-3797
Mailing Address - Country:US
Mailing Address - Phone:615-684-0522
Mailing Address - Fax:931-684-6238
Practice Address - Street 1:604 S WALL ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-3797
Practice Address - Country:US
Practice Address - Phone:931-684-0522
Practice Address - Fax:931-684-6238
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16269363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health