Provider Demographics
NPI:1215525738
Name:BARBER, RECHELLE CARPENTER (RN)
Entity type:Individual
Prefix:
First Name:RECHELLE
Middle Name:CARPENTER
Last Name:BARBER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RECHELE
Other - Middle Name:
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3267 PAULINE DR
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-3639
Mailing Address - Country:US
Mailing Address - Phone:601-259-3120
Mailing Address - Fax:
Practice Address - Street 1:3267 PAULINE DR
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-3639
Practice Address - Country:US
Practice Address - Phone:601-259-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR875334163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse