MEDICARE: MRS. REBECCA LYNN GUICE PA-C

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	363A00000X	Physician Assistant	MS00320	MS

General Provider Information

NPI Number	:	1811445414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA LYNN GUICE PA-C

Provider Business Mailing Address
First Line	:	24 MARKS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-4350
Country	:	US
Telephone Number	:	228-872-8873
Fax Number	:	228-872-8876

Provider Business Practice Location Address
First Line	:	24 MARKS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-4350
Country	:	US
Telephone Number	:	228-872-8873
Fax Number	:	228-872-8876

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

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	10/22/2024

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