Provider Demographics
NPI:1821860925
Name:PLOWDEN, REBEKAH LYNN
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNN
Last Name:PLOWDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MEADOWOODS TER
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3043
Mailing Address - Country:US
Mailing Address - Phone:919-748-9001
Mailing Address - Fax:
Practice Address - Street 1:36 MEADOWOODS TER
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-3043
Practice Address - Country:US
Practice Address - Phone:919-748-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340535183700000X
MS218239183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician