Provider Demographics
NPI:1356122303
Name:SKEEN, REBECCA BROOKE (FNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:BROOKE
Last Name:SKEEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:BROOKE
Other - Last Name:SCROGGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 SHOPPERS WAY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0530
Mailing Address - Country:US
Mailing Address - Phone:912-275-8028
Mailing Address - Fax:
Practice Address - Street 1:106 SHOPPERS WAY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0530
Practice Address - Country:US
Practice Address - Phone:912-275-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN254434363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care