Healthcare Provider Details

I. General information

NPI: 1295370088
Provider Name (Legal Business Name): NATALIE KATHLEEN PACE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE PACE RICH BSN RN, FNP-C

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 557
JACKSON MS
39216-4661
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 601-200-4560
  • Fax:
Mailing address:
  • Phone: 601-200-6060
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number907426
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number904978
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: