Healthcare Provider Details

I. General information

NPI: 1992652804
Provider Name (Legal Business Name): REBECCA LYNN MCTAGGART APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 COSHOCTON AVE
MOUNT VERNON OH
43050-1495
US

IV. Provider business mailing address

6880 COUNTY ROAD 109
MOUNT GILEAD OH
43338-9408
US

V. Phone/Fax

Practice location:
  • Phone: 740-393-9714
  • Fax: 740-399-3139
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0041703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: