Provider Demographics
NPI:1124483235
Name:BEECROFT, REBECCA LYNN (AGPCNP-BC, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:BEECROFT
Suffix:
Gender:F
Credentials:AGPCNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5191 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-6944
Mailing Address - Country:US
Mailing Address - Phone:775-526-8747
Mailing Address - Fax:
Practice Address - Street 1:199 STRATTON RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4890
Practice Address - Country:US
Practice Address - Phone:802-775-7798
Practice Address - Fax:802-775-7762
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0136813363LP0808X, 363LA2200X
WV123790363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health