Provider Demographics
NPI:1851000848
Name:HOUSTON, REBECCA JEWELL (NP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JEWELL
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:240 HIGH PINE DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-9304
Mailing Address - Country:US
Mailing Address - Phone:502-548-4756
Mailing Address - Fax:
Practice Address - Street 1:130 W JOE B HALL AVE
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6028
Practice Address - Country:US
Practice Address - Phone:502-921-1231
Practice Address - Fax:502-921-1275
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3018552363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health