Provider Demographics
NPI:1982248100
Name:PRESLEY, REBEKAH JOY (FNP-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JOY
Last Name:PRESLEY
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 1:10714 E 122ND ST N
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-5557
Mailing Address - Country:US
Mailing Address - Phone:918-277-4474
Mailing Address - Fax:
Practice Address - Street 1:1751 N ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1197
Practice Address - Country:US
Practice Address - Phone:918-794-6008
Practice Address - Fax:918-615-6548
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK98182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily