Provider Demographics
NPI:1952021867
Name:SUSSMAN, RACHEL C (APRN-CNP PMHNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:SUSSMAN
Suffix:
Gender:F
Credentials:APRN-CNP PMHNP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:C
Other - Last Name:GILBERTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6720 VIA AUSTI PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3568
Mailing Address - Country:US
Mailing Address - Phone:702-463-4050
Mailing Address - Fax:702-463-7881
Practice Address - Street 1:6720 VIA AUSTI PKWY STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3568
Practice Address - Country:US
Practice Address - Phone:702-463-4050
Practice Address - Fax:702-463-7881
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811663363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health