Provider Demographics
NPI:1144581984
Name:MEYER, REBECCA E (RN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:E
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:CLASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-533-4786
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:678-207-4373
Practice Address - Fax:770-533-4727
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN176382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125392AMedicaid
GA202I509549Medicare UPIN