Provider Demographics
NPI:1881023760
Name:KELLEY, RACHEL BAILEY (PMHNP, APRN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BAILEY
Last Name:KELLEY
Suffix:
Gender:F
Credentials:PMHNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N 4TH ST
Mailing Address - Street 2:PO BOX 1557
Mailing Address - City:HIGHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28741
Mailing Address - Country:US
Mailing Address - Phone:828-526-3241
Mailing Address - Fax:828-482-9019
Practice Address - Street 1:209 N 4TH ST
Practice Address - Street 2:UPSTAIRS AND REAR ENTRANCE
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741
Practice Address - Country:US
Practice Address - Phone:828-526-3241
Practice Address - Fax:828-482-9019
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3014332363LP0808X
NC50105392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5010539OtherAPRN STATE LICENSE