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General NPI Number Information
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NPI Number | 1831185925
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Entity Type | Individual
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Provider Name | REBECCA L MCKINTOSH ACNP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 9229 LBJ FWY
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City | DALLAS
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State | TX
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Zip | 75243-3405
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Country | US
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Telephone | 817-589-4628
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Fax | 817-447-1135
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Provider Business Mailing Address
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Address Line | 1604 BARREL OAK DRIVE
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City | BURLESSON
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State | TX
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Zip | 76028
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Country | US
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Telephone | 817-875-3417
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 577780
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License Number State | TX
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