Doctor Name: | REBECCA TOOTHMAN |
NPI Number: | 1053786608 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN166987 |
Business Practice Address: | 960 Joe Frank Harris Pkwy Se Cartersville, GA - 301202129 |
Business Phone Number: | 7703821530 |
Business Fax Number: | |
Mailing Address: | 960 Joe Frank Harris Pkwy Se, CARTERSVILLE |
State: | GA |
Postal Code: | 301202129 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/08/2015 |
NPI Last Update Date: | 12/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN166987 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |