Provider Demographics
NPI:1376723148
Name:ESPEY, REBECCA ELON EVERETT (NP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ELON EVERETT
Last Name:ESPEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ELON
Other - Middle Name:EVERETT
Other - Last Name:ESPEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:700 NORTHSIDE DRIVE
Mailing Address - Street 2:P.O. BOX 470
Mailing Address - City:NEWTON
Mailing Address - State:MS
Mailing Address - Zip Code:39345-0470
Mailing Address - Country:US
Mailing Address - Phone:601-683-4300
Mailing Address - Fax:601-683-4303
Practice Address - Street 1:701 NORTHSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MS
Practice Address - Zip Code:39345-0470
Practice Address - Country:US
Practice Address - Phone:601-683-4300
Practice Address - Fax:601-683-4303
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850861363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily