Provider Demographics
NPI:1639831217
Name:VANN, REBECCA (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VANN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N US HIGHWAY 441 STE 537
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8986
Mailing Address - Country:US
Mailing Address - Phone:352-504-3500
Mailing Address - Fax:352-504-3388
Practice Address - Street 1:1400 N US HIGHWAY 441 STE 537
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8986
Practice Address - Country:US
Practice Address - Phone:352-504-3500
Practice Address - Fax:352-504-3388
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X
FL11015843363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care