Provider Demographics
NPI:1144536509
Name:PEERY, REBEKAH P (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:P
Last Name:PEERY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:PEERY
Other - Last Name:SNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5175
Mailing Address - Fax:276-988-5941
Practice Address - Street 1:388 BEN BOLT AVE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-5386
Practice Address - Country:US
Practice Address - Phone:276-988-8740
Practice Address - Fax:276-988-5941
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX712045363LF0000X
VA0024176105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily