Provider Demographics
NPI:1942258744
Name:BRIGGS, REBECCA E (FNP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:E
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6386 GREELEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:COULTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95311
Mailing Address - Country:US
Mailing Address - Phone:209-878-0155
Mailing Address - Fax:209-878-0145
Practice Address - Street 1:6386 GREELEY HILL RD
Practice Address - Street 2:
Practice Address - City:COULTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95311-9572
Practice Address - Country:US
Practice Address - Phone:916-689-4111
Practice Address - Fax:916-689-6620
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14537363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01114968OtherRAILROAD MEDICARE
CAP01114968OtherRAILROAD MEDICARE