Provider Demographics
NPI:1942237771
Name:PEARCE, REBECCA J (APN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:J
Last Name:PEARCE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:J
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0629
Mailing Address - Country:US
Mailing Address - Phone:870-235-3550
Mailing Address - Fax:
Practice Address - Street 1:104 E COLUMBIA
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2436
Practice Address - Country:US
Practice Address - Phone:870-235-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR01942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR198840758Medicaid