Provider Demographics
NPI:1700490976
Name:CHEVALIER, REBECCA M (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3519
Mailing Address - Country:US
Mailing Address - Phone:413-237-7822
Mailing Address - Fax:
Practice Address - Street 1:39 FOREST RD
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3519
Practice Address - Country:US
Practice Address - Phone:413-237-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2273391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily