Provider Demographics
NPI:1821350232
Name:AMOS, REBECCA LYNN (BSN-C APN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:AMOS
Suffix:
Gender:F
Credentials:BSN-C APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:319 W PARKER ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-3121
Mailing Address - Country:US
Mailing Address - Phone:870-853-8271
Mailing Address - Fax:870-853-8932
Practice Address - Street 1:319 W PARKER ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:AR
Practice Address - Zip Code:71646-3121
Practice Address - Country:US
Practice Address - Phone:870-853-8271
Practice Address - Fax:870-853-8932
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01002ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily