Provider Demographics
NPI:1205963915
Name:DAMIN, REBECCA S (RN-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:DAMIN
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 WADE LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:27231-9700
Mailing Address - Country:US
Mailing Address - Phone:336-562-2685
Mailing Address - Fax:
Practice Address - Street 1:923 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4141
Practice Address - Country:US
Practice Address - Phone:919-220-4224
Practice Address - Fax:919-220-7390
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165551163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health