Provider Demographics
NPI:1710527098
Name:ESTES, REBECCA ROSS (CRNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ROSS
Last Name:ESTES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:MARCHE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6701 AIRPORT BLVD STE D100
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6765
Mailing Address - Country:US
Mailing Address - Phone:251-607-6117
Mailing Address - Fax:251-219-0746
Practice Address - Street 1:6701 AIRPORT BLVD STE D100
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6765
Practice Address - Country:US
Practice Address - Phone:251-607-6117
Practice Address - Fax:251-219-0746
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905707363LF0000X
AL1-160040363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL512-36869OtherBCBS