Healthcare Provider Details

I. General information

NPI: 1750918348
Provider Name (Legal Business Name): REBECCA JEANETTE PRATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 DOCTORS CIR BLDG C
WILMINGTON NC
28401-7403
US

IV. Provider business mailing address

504 CREEK BED CIR NW
MADISON AL
35757-6348
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-7500
  • Fax:
Mailing address:
  • Phone: 334-730-3944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number042.0017792
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2025-02740
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: