Provider Demographics
NPI:1316758956
Name:PICKETT, RACHEL MAE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MAE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 NUCKOLLS AVE
Mailing Address - Street 2:
Mailing Address - City:KEVIL
Mailing Address - State:KY
Mailing Address - Zip Code:42053-8626
Mailing Address - Country:US
Mailing Address - Phone:270-254-1704
Mailing Address - Fax:
Practice Address - Street 1:120 BRETT CHASE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5766
Practice Address - Country:US
Practice Address - Phone:270-254-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4034101363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health