Robertson, Rebecca Holly T

Robertson, Rebecca Holly T is an individual health care provider with primary practice located at 122 Airways Pl , Southaven MS 38671-5872. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Robertson, Rebecca Holly T can be contacted via phone (662) 349-9990.

Contact Information

Primary practice address
122 Airways Pl Southaven MS 38671-5872
Fax: (662) 349-2620
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R851350 Mississippi

Profile Details

NPI number 1033221106
LBN Legal business name Robertson, Rebecca Holly T
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Apr 19th, 2021 - about 3 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 1033221106 NPPES
Mississippi MEDICAID 00120194

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