Hartzog, Rebecca B
Hartzog, Rebecca B is an sole proprietor health care provider with primary practice located at 1 Lincoln Pkwy Ste 304 , Hattiesburg MS 39402-3261. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Hartzog, Rebecca B can be contacted via phone (601) 261-1750.Contact Information
Primary practice address
1 Lincoln Pkwy Ste 304
Hattiesburg MS 39402-3261
Phone: (601) 261-1750
Fax: (601) 261-1755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | R876189 | Mississippi |
Profile Details
| NPI number | 1215267018 |
|---|---|
| LBN Legal business name | Hartzog, Rebecca B |
| Credentials | PMHNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 30th, 2009 |
| Last updated | Aug 11th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215267018 | NPPES |
| Mississippi | MEDICAID | 04973557 |
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