Provider Demographics
NPI:1609192368
Name:HILLIS, REBEKAH SUZANNE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:SUZANNE
Last Name:HILLIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CLEVELAND STREET
Mailing Address - Street 2:SUITE 270
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-2856
Mailing Address - Country:US
Mailing Address - Phone:931-484-7596
Mailing Address - Fax:931-484-7597
Practice Address - Street 1:49 CLEVELAND STREET
Practice Address - Street 2:SUITE 270
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-2856
Practice Address - Country:US
Practice Address - Phone:931-484-7596
Practice Address - Fax:931-484-7597
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14775363LF0000X
TNAPN0000014775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily