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General NPI Number Information
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NPI Number | 1750960530
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Entity Type | Individual
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Provider Name | REBECCA CHAMBERS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 150 E PONCE DE LEON AVE STE 235
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City | DECATUR
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State | GA
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Zip | 30030-2553
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Country | US
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Telephone | 404-273-7406
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Fax |
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Provider Business Mailing Address
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Address Line | 766 WILLIVEE DR
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City | DECATUR
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State | GA
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Zip | 30033-5411
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Country | US
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Telephone | 678-595-3416
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN259042
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License Number State | GA
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