Provider Demographics
NPI:1245670629
Name:MCKINNEY, REBECCA CLAIRE
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:CLAIRE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94117 FIDDLERS WALK LN
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-1660
Mailing Address - Country:US
Mailing Address - Phone:904-624-4802
Mailing Address - Fax:
Practice Address - Street 1:94117 FIDDLERS WALK LN
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-1660
Practice Address - Country:US
Practice Address - Phone:904-624-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula