Individual
REBEKAH LYNN MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
525 TUCKER DR, MAYSVILLE, KY 41056-9182
(606) 759-9921
(606) 759-9831
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7906
(615) 920-8938
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010733
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100453290
—
KY
01
—
K228540
MEDICARE
KY
Enumeration date
10/13/2016
Last updated
01/07/2020
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