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General NPI Number Information
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NPI Number | 1962063883
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Entity Type | Individual
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Provider Name | REBECCA HALECHKO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 2969 PELHAM PKWY STE C
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City | PELHAM
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State | AL
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Zip | 35124-1730
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Country | US
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Telephone | 205-624-4325
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Fax | 205-620-6776
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Provider Business Mailing Address
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Address Line | 174 RIVER VALLEY RD
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City | HELENA
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State | AL
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Zip | 35080-8604
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Country | US
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Telephone | 205-283-4381
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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 | 1-110307
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License Number State | AL
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