Individual
REBECCA FANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6002 SLIDE RD # D24, LUBBOCK, TX 79414-4310
(806) 761-0450
(806) 796-7259
Mailing address
5219 CITY BANK PKWY, SUITE 35, LUBBOCK, TX 79407-3544
(806) 761-0707
(806) 761-0708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
617399
TX
363L00000X
Nurse Practitioner
Primary
AP110620
TX
363LF0000X
Family Nurse Practitioner
AP110620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145684002
—
TX
Enumeration date
04/20/2006
Last updated
11/17/2021
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