Provider Demographics
NPI:1801386362
Name:MECKFESSEL, REBECCA (FNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MECKFESSEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:KOBISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4630 LONG PRAIRIE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1758
Mailing Address - Country:US
Mailing Address - Phone:469-495-9112
Mailing Address - Fax:
Practice Address - Street 1:4630 LONG PRAIRIE RD STE 210
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1758
Practice Address - Country:US
Practice Address - Phone:469-495-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137086363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily