Provider Demographics
NPI:1386959351
Name:RACHAL, ANGELA CLARK (WHNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CLARK
Last Name:RACHAL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-374-0220
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5131 ODONOVAN DR STE 200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4791
Practice Address - Country:US
Practice Address - Phone:225-374-0220
Practice Address - Fax:225-374-0221
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014828363LW0102X
LAAP06238363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95014828OtherCA NP LICENSE
LAPA080093OtherLA PRESCRIPTIVE AUTHORITY
LAAP06238OtherNP LICENSE #