Provider Demographics
NPI:1811445414
Name:GUICE, REBECCA LYNN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:GUICE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MARKS RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-4350
Mailing Address - Country:US
Mailing Address - Phone:228-872-8873
Mailing Address - Fax:228-872-8876
Practice Address - Street 1:24 MARKS RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-4350
Practice Address - Country:US
Practice Address - Phone:228-872-8873
Practice Address - Fax:228-872-8876
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS00320363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant