Provider Demographics
NPI: | 1225308133 |
---|---|
Name: | SOLIS, REBEKAH E (RN,MSN,FNPBC) |
Entity Type: | Individual |
Prefix: | |
First Name: | REBEKAH |
Middle Name: | E |
Last Name: | SOLIS |
Suffix: | |
Gender: | F |
Credentials: | RN,MSN,FNPBC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1509 DULLES DR |
Mailing Address - Street 2: | |
Mailing Address - City: | LAFAYETTE |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70506-3718 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 337-991-9276 |
Mailing Address - Fax: | 337-943-0846 |
Practice Address - Street 1: | 3901A SPICEWOOD SPRINGS RD |
Practice Address - Street 2: | |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78759-8723 |
Practice Address - Country: | US |
Practice Address - Phone: | 379-919-2763 |
Practice Address - Fax: | 379-430-8463 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2012-01-09 |
Last Update Date: | 2022-12-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 638655 | 363L00000X |
TX | AP117582 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 638655 | Other | RN LIC # |