Provider Demographics
NPI:1649792045
Name:BARTLETT, REBECCA ANNE (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 TORIA DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3792
Mailing Address - Country:US
Mailing Address - Phone:318-542-0706
Mailing Address - Fax:
Practice Address - Street 1:3335 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3916
Practice Address - Country:US
Practice Address - Phone:318-442-9395
Practice Address - Fax:318-442-9548
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily