Provider Demographics
NPI:1669648036
Name:MCINTIRE, REBECCA LYNN (APRN, FNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:76424-4711
Mailing Address - Country:US
Mailing Address - Phone:254-559-3363
Mailing Address - Fax:254-559-5561
Practice Address - Street 1:101 S HARTFORD ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4711
Practice Address - Country:US
Practice Address - Phone:254-559-3363
Practice Address - Fax:254-559-5561
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP107992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily