Healthcare Provider Details

I. General information

NPI: 1265272686
Provider Name (Legal Business Name): REBECCA NOEL HEGWOOD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MARKET PLACE BLVD STE 200
CARTERSVILLE GA
30121-8716
US

IV. Provider business mailing address

221 TECHNOLOGY PKWY NW
ROME GA
30165-1369
US

V. Phone/Fax

Practice location:
  • Phone: 770-386-7253
  • Fax: 678-385-4594
Mailing address:
  • Phone: 762-235-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNNP192458
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: