Provider Demographics
NPI:1336855097
Name:FIELDS, RACINE (RN, BSN)
Entity type:Individual
Prefix:
First Name:RACINE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:RACINE
Other - Middle Name:J
Other - Last Name:FIELDS-GREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:2285 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-3154
Mailing Address - Country:US
Mailing Address - Phone:225-218-5647
Mailing Address - Fax:225-259-3821
Practice Address - Street 1:2285 NORTH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-3154
Practice Address - Country:US
Practice Address - Phone:225-218-5647
Practice Address - Fax:225-259-3821
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9533277163W00000X
LARN115553163WA0400X, 163WP0808X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health