Provider Demographics
NPI:1750960530
Name:CHAMBERS, REBECCA (FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 WILLIVEE DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5411
Mailing Address - Country:US
Mailing Address - Phone:678-595-3416
Mailing Address - Fax:
Practice Address - Street 1:150 E PONCE DE LEON AVE STE 235
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2553
Practice Address - Country:US
Practice Address - Phone:404-273-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN259042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily