Healthcare Provider Details

I. General information

NPI: 1336147818
Provider Name (Legal Business Name): REBECCA LYNN IRBY ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 YAKIN ST SUITE C
ALBEMARLE NC
28001
US

IV. Provider business mailing address

303 YADKIN ST STE C
ALBEMARLE NC
28001-3452
US

V. Phone/Fax

Practice location:
  • Phone: 980-323-4667
  • Fax:
Mailing address:
  • Phone: 704-982-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number900388
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number900388
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: