Individual
REBAKAH LYNNLEE HUEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP - PC/AC
Contact information
Practice address
848 ADAMS AVE, MEMPHIS, TN 38103-2816
(866) 870-5570
Mailing address
2093 RACHEL ST, TUPELO, MS 38804-1633
(625) 236-0566
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
31385
TN
363LP0200X
Pediatric Nurse Practitioner
902310
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05937047
—
MS
Enumeration date
01/23/2018
Last updated
11/25/2024
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