Provider Demographics
NPI:1336855097
Name:FIELDS, RACINE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:RACINE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:RACINE
Other - Middle Name:J
Other - Last Name:FIELDS-GREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:1217 PEAR ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-5053
Mailing Address - Country:US
Mailing Address - Phone:225-678-2388
Mailing Address - Fax:
Practice Address - Street 1:4184 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3911
Practice Address - Country:US
Practice Address - Phone:225-678-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health