Provider Demographics
NPI:1205373750
Name:BLACKSON, REBECCA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BLACKSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:OVERFELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3231 SW 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8489
Mailing Address - Country:US
Mailing Address - Phone:352-873-7400
Mailing Address - Fax:354-873-7464
Practice Address - Street 1:3231 SW 34TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8489
Practice Address - Country:US
Practice Address - Phone:352-873-7400
Practice Address - Fax:354-873-7464
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9312651208D00000X
FLAPRN9312651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice