MEDICARE: MRS. REBECCA LOUISE STRUNK CRNP

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
1	363LF0000X	Family Nurse Practitioner	1-134043	AL

General Provider Information

NPI Number	:	1235487166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA LOUISE STRUNK CRNP

Provider Business Mailing Address
First Line	:	P.O. BOX 97
Second Line	:
City	:	GADSDEN
State	:	AL
Zip	:	35902-0097
Country	:	US
Telephone Number	:	256-492-0131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1989 SARDIS DRIVE
Second Line	:
City	:	SARDIS CITY
State	:	AL
Zip	:	35956-2344
Country	:	US
Telephone Number	:	256-593-2371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	05/09/2016

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