MEDICARE: MRS. REBECCA D ACOSTA APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1217448	TX

General Provider Information

NPI Number	:	1649156563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA D ACOSTA APRN, FNP-BC

Provider Business Mailing Address
First Line	:	671 E BROAD ST
Second Line	:	SUITE 103 1049
City	:	MANSFIELD
State	:	TX
Zip	:	76063
Country	:	US
Telephone Number	:	817-587-8291
Fax Number	:	817-612-3184

Provider Business Practice Location Address
First Line	:	4012 SWGREEN OAKS BLVD
Second Line	:	SUITE D
City	:	ARLINGTON
State	:	TX
Zip	:	76017
Country	:	US
Telephone Number	:	817-587-8291
Fax Number	:	817-612-3184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	05/22/2026

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