Provider Demographics
NPI:1629522024
Name:SMITHEY, REBEKAH (NP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:SMITHEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 POINTE NORTH DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-7911
Mailing Address - Country:US
Mailing Address - Phone:678-721-0705
Mailing Address - Fax:678-721-5116
Practice Address - Street 1:21 POINTE NORTH DR
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-7911
Practice Address - Country:US
Practice Address - Phone:678-721-0705
Practice Address - Fax:678-721-5116
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily