Provider Demographics
NPI:1205364783
Name:OHEARN, REBECCA SHEPHERD (FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SHEPHERD
Last Name:OHEARN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 ALSTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31825-6012
Mailing Address - Country:US
Mailing Address - Phone:229-887-3324
Mailing Address - Fax:229-887-2559
Practice Address - Street 1:510 ALSTON ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:GA
Practice Address - Zip Code:31825-6012
Practice Address - Country:US
Practice Address - Phone:229-887-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily