Individual provider Active NPI

Rebecca Etta, ACPN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lewisville, TX
National Provider Identifier
1952560054
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP116817 Issued in TX
Practice address
2300 Rockbrook Dr
Suite 100 C
Lewisville, TX 75067-8181
Phone
(972) 459-6632
Fax
(972) 459-6626
NPI assigned
Jun 3, 2008
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP116817 TX Primary
Acute Care Nurse Practitioner 363LA2100X 662521 TX

Addresses

Primary practice location

2300 Rockbrook Dr
Suite 100 C
Lewisville, TX 75067-8181

Mailing address

2300 Rockbrook Dr
Suite 100 C
Lewisville, TX 75067-8181
Phone (972) 459-6632

Other identifiers 2

IdentifierTypeStateIssuer
211017301MedicaidTX
8F23642OtherTXMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000454 TX Practitioner - Nurse Practitioner 5698823524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2300 Rockbrook Dr
Suite 100C
Lewisville, TX 75067-8181
Phone (972) 459-6632

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth House Calls Services Inc. Acute Care CurrentSince Dec 1, 2009 Accepting new patients
Prohealth House Calls Services Inc Acute Care Current Accepting new patients

Locations

2300 Rockbrook Dr
Ste 100C
Lewisville, TX 75067
Phone (972) 459-6632

2300 Rockbrook Dr
Ste C
Lewisville, TX 75067
Phone (972) 459-6632

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1952560054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 ROCKBROOK DR",
            "address_2": "SUITE 100 C",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750678181",
            "telephone_number": "972-459-6632",
            "fax_number": "972-459-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 ROCKBROOK DR",
            "address_2": "SUITE 100 C",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750678181",
            "telephone_number": "972-459-6632",
            "fax_number": "972-459-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTA",
        "first_name": "REBECCA",
        "credential": "ACPN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP116817",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "662521",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211017301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8F23642",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.