Provider Demographics
NPI:1730594417
Name:MCKELVEY, REBEKAH COCKE (FNP)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:COCKE
Last Name:MCKELVEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 MEADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CALLAWAY
Mailing Address - State:VA
Mailing Address - Zip Code:24067-4636
Mailing Address - Country:US
Mailing Address - Phone:540-520-3897
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-981-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-21
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily