Healthcare Provider Details

I. General information

NPI: 1144639584
Provider Name (Legal Business Name): REBECCA WEHNER HEWITT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9066 CYPRESS GREEN DR
JACKSONVILLE FL
32256-7791
US

IV. Provider business mailing address

9066 CYPRESS GREEN DR
JACKSONVILLE FL
32256-7791
US

V. Phone/Fax

Practice location:
  • Phone: 904-260-2001
  • Fax: 904-260-2010
Mailing address:
  • Phone: 904-260-2001
  • Fax: 904-260-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9181122
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: