Derby, Rebecca D

Derby, Rebecca D is an individual health care provider with primary practice located at 980 Professional Park Dr Ste. C, Clarksville TN 37040-5251. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Derby, Rebecca D can be contacted via phone (931) 647-5747.

Contact Information

Primary practice address
980 Professional Park Dr Ste. C Clarksville TN 37040-5251
Phone: (931) 647-5747
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 20361 Tennessee

Profile Details

NPI number 1053789149
LBN Legal business name Derby, Rebecca D
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2015
Last updated Jul 1st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053789149 NPPES
Tennessee MEDICAID Q016334

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