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Individual

REBECCA E EWALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, CPNP

Contact information

Practice address
590 RADIO HILL RD, SUITE 1 MEDICAL ARTS BUILDING, MARION, VA 24354-4224
(276) 783-8183
(276) 782-9267
Mailing address
590 RADIO HILL RD, SUITE 1 MEDICAL ARTS BUILDING, MARION, VA 24354-4224
(276) 783-8183
(276) 782-9267

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0017137762
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017137762
VIRGINIA LIS.
VA
Enumeration date
08/29/2005
Last updated
06/28/2012
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