Healthcare Provider Details

I. General information

NPI: 1285523191
Provider Name (Legal Business Name): REBECCA AREE BRACKEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE FL 3
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

11418 ROCKVILLE PIKE APT E401
NORTH BETHESDA MD
20852-3092
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-2400
  • Fax:
Mailing address:
  • Phone: 443-876-5638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN322719
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: