Provider Demographics
NPI:1881873560
Name:SOMMERS, REBECCA LYNN (PA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:SOMMERS
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1195 OLD HICKORY BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4239
Mailing Address - Country:US
Mailing Address - Phone:615-373-2000
Mailing Address - Fax:615-891-5021
Practice Address - Street 1:1195 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4239
Practice Address - Country:US
Practice Address - Phone:615-373-2000
Practice Address - Fax:615-891-5001
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2024-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNPA1539363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3665156Medicaid
TN3665156Medicare PIN