Provider Demographics
NPI:1902181209
Name:SOOD, RACHAEL GORNEY (NP)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:GORNEY
Last Name:SOOD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:GORNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6320
Mailing Address - Country:US
Mailing Address - Phone:504-836-9820
Mailing Address - Fax:504-836-9696
Practice Address - Street 1:2005 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6320
Practice Address - Country:US
Practice Address - Phone:504-836-9820
Practice Address - Fax:504-836-9608
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN115872363LF0000X
LAAP06690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2166441Medicaid
MS04900013Medicaid
LA2166441Medicaid