Provider Demographics
NPI:1205584893
Name:HOLTSFORD, REBECCA HAILS (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:HAILS
Last Name:HOLTSFORD
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 CARMICHAEL PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2359
Mailing Address - Country:US
Mailing Address - Phone:334-309-6979
Mailing Address - Fax:
Practice Address - Street 1:5741 CARMICHAEL PKWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2359
Practice Address - Country:US
Practice Address - Phone:334-309-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-144192363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily