Individual
RACHAEL J WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
969 LAKELAND DRIVE, ST. DOMINIC PALLIATIVE CARE, JACKSON, MS 39216
(601) 200-5900
(601) 200-0204
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(601) 200-5900
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
884972
MS
363L00000X
Nurse Practitioner
F0814571
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02505821
—
MS
01
—
1V8513
MEDICARE (ST DOM)
MS
Enumeration date
10/09/2014
Last updated
04/08/2024
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