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General NPI Number Information
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NPI Number | 1366197402
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Entity Type | Individual
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Provider Name | REBEKAH PAIGE PETRIELLA FNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 6047 TYVOLA GLEN CIR
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City | CHARLOTTE
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State | NC
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Zip | 28217-6431
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Country | US
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Telephone | 443-383-9300
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Fax | 855-866-8710
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Provider Business Mailing Address
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Address Line | 1230 26TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-7611
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Country | US
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Telephone | 828-962-8481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1151725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.28370
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5015845
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License Number State | NC
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