Provider Demographics
NPI:1790072783
Name:MOBLEY, REBECCA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RENEE
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31776-1387
Mailing Address - Country:US
Mailing Address - Phone:229-502-9735
Mailing Address - Fax:229-502-9733
Practice Address - Street 1:15 HOSPITAL PARK
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-6772
Practice Address - Country:US
Practice Address - Phone:229-502-9735
Practice Address - Fax:229-502-9733
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN192380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily