Provider Demographics
NPI:1164734646
Name:PATENODE, RACHEL A (FNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:PATENODE
Suffix:
Gender:F
Credentials:FNP, PMHNP-BC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:WADDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, PMHNP-BC
Mailing Address - Street 1:307 SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2828
Mailing Address - Country:US
Mailing Address - Phone:605-431-8537
Mailing Address - Fax:
Practice Address - Street 1:307 SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2828
Practice Address - Country:US
Practice Address - Phone:605-399-4300
Practice Address - Fax:605-399-4352
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR033758363L00000X
SDCP000594363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health