Provider Demographics
NPI:1932473261
Name:WEIR, REBECCA MCCLAIN (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MCCLAIN
Last Name:WEIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 MUELLER BRASS RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-3754
Mailing Address - Country:US
Mailing Address - Phone:901-476-0235
Mailing Address - Fax:901-476-0229
Practice Address - Street 1:4700 MUELLER BRASS RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3754
Practice Address - Country:US
Practice Address - Phone:901-476-0235
Practice Address - Fax:901-476-0229
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN158873163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health