Rebecca Wilson Kelley, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-114513 Issued in AL

Practice address

2350 Hargrove Rd E
Tuscaloosa, AL 35405-2612

Phone

(205) 562-6900

Fax

(205) 759-4039

NPI assigned

Nov 14, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Rebecca Jean Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1417499096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MONROE ST",
            "address_2": "SUITE 1350",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361043735",
            "telephone_number": "334-206-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 HARGROVE RD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354052612",
            "telephone_number": "205-562-6900",
            "fax_number": "205-759-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "REBECCA",
        "middle_name": "WILSON",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-114513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WILSON",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gopal K Kaza, MD
• Stephanie Leigh Keasler, ADC
• Tyler Keenum, CRNP
• Kimberley R Keller, RPH
• Karen Kelley, CRNP
• Marion Kellough, L.C.S.W.
• Bettienne Kelly, LBSW
• Kirsten Lynn Kelly, PHARMD
• Lacy S. Kelly, CRNA
• Stephen James Kelton, M.D.

• Family Nurse Practitioner in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.