Provider Demographics
NPI:1679873194
Name:NELSON, REBECCA GARRETT (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:GARRETT
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 FALLS OF NEUSE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5316
Mailing Address - Country:US
Mailing Address - Phone:919-847-0900
Mailing Address - Fax:919-861-2106
Practice Address - Street 1:7409 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5316
Practice Address - Country:US
Practice Address - Phone:919-847-0900
Practice Address - Fax:919-861-2106
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily