Provider Demographics
NPI:1003055617
Name:GEORGE, RACHEL LORRAINE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LORRAINE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LORRAINE
Other - Last Name:RAULS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2725 ANDREW AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39567-1815
Mailing Address - Country:US
Mailing Address - Phone:228-762-0713
Mailing Address - Fax:228-769-7484
Practice Address - Street 1:2725 ANDREW AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-1815
Practice Address - Country:US
Practice Address - Phone:228-762-0713
Practice Address - Fax:228-769-7484
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR660906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07753202Medicaid