Provider Demographics
NPI:1760886717
Name:ATKINS, REBEKAH R (NP-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:R
Last Name:ATKINS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 PRIMERA BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2149
Mailing Address - Country:US
Mailing Address - Phone:407-321-0085
Mailing Address - Fax:
Practice Address - Street 1:735 PRIMERA BLVD STE 135
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2149
Practice Address - Country:US
Practice Address - Phone:407-321-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9331266163WP0200X
FLARNP9331266363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics