Provider Demographics
NPI:1831603489
Name:STANSBERRY, REBEKAH (NP-C)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:STANSBERRY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2504
Mailing Address - Country:US
Mailing Address - Phone:423-838-0565
Mailing Address - Fax:
Practice Address - Street 1:615 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2598
Practice Address - Country:US
Practice Address - Phone:423-838-0565
Practice Address - Fax:423-838-0565
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22629363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily