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NPI Code Detail

MEDICARE: REBECCA BERRIER EVANS CNM, FNP-BC

MEDICARE: REBECCA BERRIER EVANS CNM, 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
1367A00000XAdvanced Practice MidwifeRN145456GA
2363L00000XNurse PractitionerRN145456GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942293154
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA BERRIER EVANS CNM, FNP-BC
Provider Business Mailing Address
First Line : 1825 MARTHA BERRY BLVD NW
Second Line :
City : ROME
State : GA
Zip : 30165-1625
Country : US
Telephone Number : 706-295-5331
Fax Number :
Provider Business Practice Location Address
First Line : 150 GENTILLY BLVD
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-8522
Country : US
Telephone Number : 770-382-5611
Fax Number : 770-382-8381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 04/18/2013

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Directions to “ REBECCA BERRIER EVANS CNM, FNP-BC” Practice Location

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