Rebecca Lynn Derossett, FNP
Individual provider Active NPI Family Nurse Practitioner · Huntington, WV
NPI 1194375576 · NPPES record last updated Dec 17, 2023
Key facts
- NPI
- 1194375576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 102685 (WV)
- Practice address
- 1415 6TH Ave # a
Huntington, WV 25701-2420 - Phone
- (304) 522-1142
- NPI assigned
- Sep 17, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191030000092 | WV | Practitioner - Nurse Practitioner | 3577895242 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coalfield Family Services, PLLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 102685 | WV | Yes |
Addresses
Primary practice location
1415 6TH Ave # a
Huntington, WV 25701-2420
Mailing address
103 Sansom Ave
Wayne, WV 25570-9651
Other practice location 1
11713 Route 152 Ste 1
Wayne, WV 25570-6539
Phone (681) 464-2001
Other providers in Huntington, WV
- Dustin Charles Dennison
- William Brian Dennison
- Misha Dent
- Finn Depriest
- Hannah Depriest
- Amber Desimone
- Alexis Morgan Deskins
- Andrew Stevens Desrosiers
- Naomi Lee Detemple
- Justine Detrow
All providers in Huntington, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.