MEDICARE: REBECCA WICKLIFFE RNFA

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	163WR0006X	Registered Nurse First Assistant	RN075524	LA

General Provider Information

NPI Number	:	1871623538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA WICKLIFFE RNFA

Provider Business Mailing Address
First Line	:	PO BOX 371
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-0371
Country	:	US
Telephone Number	:	225-654-0310
Fax Number	:	225-654-0310

Provider Business Practice Location Address
First Line	:	4851 W PARK DR
Second Line	:	SUITE B
City	:	ZACHARY
State	:	LA
Zip	:	70791-4010
Country	:	US
Telephone Number	:	225-654-0310
Fax Number	:	225-654-0310

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1053454108 — DR. ELENITA P SANTOS-MATA M.D.
Practice Location Address:

4851 W PARK DR , SUITE A
ZACHARY, LA
70791-4010

Practice Phone: 225-658-7636
Practice Fax: 225-658-7634

1194986893 — ZACHARY PEDIATRICS
Practice Location Address:

4851 W PARK DR , SUITE A
ZACHARY, LA
70791-4010

Practice Phone: 225-658-7636
Practice Fax:

1619802337 — CAMRYN BROUILLETTE
Practice Location Address:

4845 MAIN ST STE C
ZACHARY, LA
70791-3943

Practice Phone: 225-286-0181
Practice Fax: 225-286-0186

1477489516 — MRS. HAYLEY T BORDES PT, DPT
Practice Location Address:

1219 CHURCH ST
ZACHARY, LA
70791-2347

Practice Phone: 225-658-7751
Practice Fax: 225-658-7753

1326612821 — LAUREN MALIK CANADY
Practice Location Address:

9305 MAIN ST
ZACHARY, LA
70791-7441

Practice Phone: 225-278-1020
Practice Fax:

1780517631 — JACELYN HASTINGS
Practice Location Address:

1215 INDEPENDENCE BLVD BLDG 6
ZACHARY, LA
70791-7390

Practice Phone: 225-286-1547
Practice Fax:

Directions to “ REBECCA WICKLIFFE RNFA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.