Provider Demographics
NPI:1093028003
Name:MCCONNAUGHY, REBECCA (MSN, RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:MCCONNAUGHY
Suffix:
Gender:F
Credentials:MSN, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:795 WILLOW RD
Mailing Address - Street 2:BUILDING 360, H-216
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2539
Mailing Address - Country:US
Mailing Address - Phone:650-493-5000
Mailing Address - Fax:650-614-9970
Practice Address - Street 1:795 WILLOW RD
Practice Address - Street 2:BUILDING 360, H-216
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-2539
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-614-9970
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily