Healthcare Provider Details

I. General information

NPI: 1710160791
Provider Name (Legal Business Name): REBECCA MEEK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3696 WHEELER RD
AUGUSTA GA
30909-6520
US

IV. Provider business mailing address

3696 WHEELER RD
AUGUSTA GA
30909-6520
US

V. Phone/Fax

Practice location:
  • Phone: 706-736-1830
  • Fax:
Mailing address:
  • Phone: 706-736-1830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP128107
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN269761
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: