Rebecca Finnemore
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Gulfport, MS
NPI 1497219794 · NPPES record last updated Sep 13, 2019
Key facts
- NPI
- 1497219794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- 88134 (MS)
- Practice address
- 1600 Broad Ave
Gulfport, MS 39501-3603 - Phone
- (228) 865-1719
- Fax
- (228) 865-1780
- NPI assigned
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88134 | MS | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 88134 | MS | Yes |
Addresses
Primary practice location
1600 Broad Ave
Gulfport, MS 39501-3603
Mailing address
1600 Broad Ave
Gulfport, MS 39501-3603
Phone (228) 865-1719
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018213 | Medicaid | MS |
Other providers in Gulfport, MS
- Teeare Kellie Fields-Parker
- Gracie Fillingame
- Bonnie Kay Fine
- Christina Fingerle
- Jeannine Michelle Finley
- Cheryl Fisher
- Daphne Ferriera Fisher
- Kimberly Fisher
- Lakeshia Fisher
- FJP LLC
All providers in Gulfport, MS · Psychiatric/Mental Health Registered Nurse in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.