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NPI Code Detail

MEDICARE: REBECCA DAUGHTRIDGE NESBITT MS

MEDICARE: REBECCA DAUGHTRIDGE NESBITT MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5051NC

General Provider Information

NPI Number : 1134252497
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA DAUGHTRIDGE NESBITT MS
Provider Business Mailing Address
First Line : 3800 SHAMROCK DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-3220
Country : US
Telephone Number : 704-532-5364
Fax Number : 704-532-5363
Provider Business Practice Location Address
First Line : 3800 SHAMROCK DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-3220
Country : US
Telephone Number : 704-532-5364
Fax Number : 704-532-5363
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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