Provider Demographics
NPI:1639957301
Name:MORRILL, REBECCA (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MORRILL
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 1:2501 N GLEBE RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3558
Mailing Address - Country:US
Mailing Address - Phone:508-663-3852
Mailing Address - Fax:
Practice Address - Street 1:24560 SOUTHPOINT DR STE 260
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3505
Practice Address - Country:US
Practice Address - Phone:571-248-7472
Practice Address - Fax:571-248-7493
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001111828163W00000X
VA0024187843363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse