=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154708071
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA CONWAY ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2015
-----------------------------------------------------
Last Update Date | 06/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16455 STATESVILLE RD STE 280
-----------------------------------------------------
City | HUNTERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28078-7134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-442-4600
-----------------------------------------------------
Fax | 980-442-4601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16455 STATESVILLE RD STE 208
-----------------------------------------------------
City | HUNTERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28078-7135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-442-4600
-----------------------------------------------------
Fax | 980-442-4601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9247717
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 5021684
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------