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NPI Code Detail

MEDICARE: REBECCA WILLIFORD

MEDICARE: REBECCA WILLIFORD
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
1363LF0000XFamily Nurse Practitioner26742SC
2363LF0000XFamily Nurse PractitionerRN232116GA

General Provider Information

NPI Number : 1316585185
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA WILLIFORD
Provider Business Mailing Address
First Line : 1220 GEORGE C WILSON DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-4501
Country : US
Telephone Number : 706-434-8304
Fax Number :
Provider Business Practice Location Address
First Line : 1220 GEORGE C WILSON DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-4501
Country : US
Telephone Number : 706-434-8304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2019
Last Update Date : 01/18/2023

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Directions to “ REBECCA WILLIFORD ” Practice Location

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