Provider Demographics
NPI:1356902860
Name:SCHICKER, REBEKAH (RN, NP-C)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:SCHICKER
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:JOY
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP-C
Mailing Address - Street 1:499 8TH ST NE APT C3
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1784
Mailing Address - Country:US
Mailing Address - Phone:616-403-0716
Mailing Address - Fax:
Practice Address - Street 1:3700 MARKET ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2653
Practice Address - Country:US
Practice Address - Phone:678-383-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily