Healthcare Provider Details

I. General information

NPI: 1982942256
Provider Name (Legal Business Name): REBECCA GARRETT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JEFFERSON ST STE 2C
LYNCHBURG VA
24504-1724
US

IV. Provider business mailing address

1167 SPRATLIN PARK DR
GRAY TN
37615-6205
US

V. Phone/Fax

Practice location:
  • Phone: 571-934-3936
  • Fax:
Mailing address:
  • Phone: 423-467-3600
  • Fax: 423-467-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024170456
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4036000
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4036000
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024170456
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170456
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: