Provider Demographics
NPI:1427596568
Name:PACE, REBECCA A (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:PACE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:LEUZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-609-3404
Mailing Address - Fax:757-410-7215
Practice Address - Street 1:713 VOLVO PKWY
Practice Address - Street 2:STE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1614
Practice Address - Country:US
Practice Address - Phone:757-609-3404
Practice Address - Fax:757-410-7215
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily