Provider Demographics
NPI:1497158885
Name:FORE, REBECCAH (CNA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCAH
Middle Name:
Last Name:FORE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 PLUS PARK BLVD UNIT 333
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1260
Mailing Address - Country:US
Mailing Address - Phone:615-708-0686
Mailing Address - Fax:
Practice Address - Street 1:331 PLUS PARK BLVD. #150
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217
Practice Address - Country:US
Practice Address - Phone:615-708-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization