Provider Demographics
NPI:1497268023
Name:SMITH, REBECCA (FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2450
Mailing Address - Country:US
Mailing Address - Phone:325-670-6180
Mailing Address - Fax:325-670-6185
Practice Address - Street 1:1904 PINE ST STE 3A
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2450
Practice Address - Country:US
Practice Address - Phone:325-670-6180
Practice Address - Fax:325-670-6185
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner