Provider Demographics
NPI:1982827374
Name:COUCH, REBECCA J (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:COUCH
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 1:2306 MONTCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1032
Mailing Address - Country:US
Mailing Address - Phone:615-890-2071
Mailing Address - Fax:
Practice Address - Street 1:2306 MONTCLAIR AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1032
Practice Address - Country:US
Practice Address - Phone:615-890-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18655163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN18655OtherRN