Provider Demographics
NPI:1780087577
Name:ABBOTT, REBECCA SUZANNE (MS, RN, PMHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:SUZANNE
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:MS, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:15708 MCCONNELLSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-8902
Mailing Address - Country:US
Mailing Address - Phone:740-305-1303
Mailing Address - Fax:
Practice Address - Street 1:15708 MCCONNELLSVILLE RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-8902
Practice Address - Country:US
Practice Address - Phone:740-305-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16454-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health