| Doctor Name: | MISS RACHEL LORRAINE STATEN |
| NPI Number: | 1124359229 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | R883957 |
| Business Practice Address: | 112 Grand Ole Oaks Dr Apt # 2 Belden, MS - 388267014 |
| Business Phone Number: | 6622692105 |
| Business Fax Number: | |
| Mailing Address: | 112 Grand Ole Oaks Dr, Apt # 2 BELDEN |
| State: | MS |
| Postal Code: | 388267014 |
| Phone Number: | 6622692105 |
| Fax Number: | |
| NPI Enumeration Date: | 01/29/2010 |
| NPI Last Update Date: | 03/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R883957 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |