Provider Demographics
NPI:1851005508
Name:ADAMS, REBEKAH DIANE (MMS)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:DIANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BRIGHT WATER LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-6001
Mailing Address - Country:US
Mailing Address - Phone:864-238-2721
Mailing Address - Fax:
Practice Address - Street 1:103 BRIGHT WATER LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-6001
Practice Address - Country:US
Practice Address - Phone:864-238-2721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant