Provider Demographics
NPI:1679596043
Name:MCALLISTER, REBECCA H (ARNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:H
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10,000 BAY PINES BLVD
Mailing Address - Street 2:BAY PINES VAMC
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:
Practice Address - Street 1:10,000 BAY PINES BLVD.
Practice Address - Street 2:BAY PINES VAMC
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-398-9370
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1270472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5261ZMedicare ID - Type Unspecified
S28138Medicare UPIN