Clanton, Rebecca B

Clanton, Rebecca B is an individual health care provider with primary practice located at 1500 E Woodrow Wilson Ave , Jackson MS 39216-5116. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Clanton, Rebecca B can be contacted via phone (601) 364-1558.

Contact Information

Primary practice address
1500 E Woodrow Wilson Ave Jackson MS 39216-5116
Phone: (601) 364-1558
Fax: (601) 368-3802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R859995 Mississippi

Profile Details

NPI number 1508827205
LBN Legal business name Clanton, Rebecca B
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Sep 16th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508827205 NPPES
Mississippi MEDICAID 05509571

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