Healthcare Provider Details

I. General information

NPI: 1497686083
Provider Name (Legal Business Name): REBECCA MARIE COONCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12310 HIGHWAY 15
NEWTON MS
39345-9194
US

IV. Provider business mailing address

12310 HIGHWAY 15
NEWTON MS
39345-9194
US

V. Phone/Fax

Practice location:
  • Phone: 601-832-7730
  • Fax:
Mailing address:
  • Phone: 601-832-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279S1500X
TaxonomySNF/Subacute Care Registered Respiratory Therapist
License Number6706
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: