Healthcare Provider Details

I. General information

NPI: 1295321578
Provider Name (Legal Business Name): REBECCA LABRIE MSN, APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10065 CORTEZ BLVD
WEEKI WACHEE FL
34613-6389
US

IV. Provider business mailing address

10065 CORTEZ BLVD
WEEKI WACHEE FL
34613-6389
US

V. Phone/Fax

Practice location:
  • Phone: 352-596-4660
  • Fax:
Mailing address:
  • Phone: 352-596-4660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9354994
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11030704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: