Healthcare Provider Details

I. General information

NPI: 1114562121
Provider Name (Legal Business Name): RACHEL M MENDONCA-HASENBEIN MSN, CRNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 RIVERCHASE GALLERIA STE 500
HOOVER AL
35244-2365
US

IV. Provider business mailing address

2200 LAKESHORE DR STE 150
BIRMINGHAM AL
35209-8832
US

V. Phone/Fax

Practice location:
  • Phone: 205-994-8811
  • Fax:
Mailing address:
  • Phone: 205-871-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-143865
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-143865
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: