Provider Demographics
NPI:1013461433
Name:LEGGETT, REX ANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:REX
Middle Name:ANNE
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REX
Other - Middle Name:ANNE
Other - Last Name:CULPEPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1047 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652-9111
Mailing Address - Country:US
Mailing Address - Phone:601-395-1158
Mailing Address - Fax:
Practice Address - Street 1:1308 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2830
Practice Address - Country:US
Practice Address - Phone:601-250-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR855476163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse