Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA.12555-NP | OH |
NPI | 1003196197 |
---|---|
Provider Name | Rebecca Lynn Scarbrough |
First Address | Athens, OH 45701 |
Second Address | Athens, OH 45701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 15/10/2012 |