Provider Demographics
NPI:1063135895
Name:TALLEY-MULLINS, REBECCA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:TALLEY-MULLINS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18055 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22942-8146
Mailing Address - Country:US
Mailing Address - Phone:540-522-3480
Mailing Address - Fax:
Practice Address - Street 1:1043 OAKLAWN DR
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3339
Practice Address - Country:US
Practice Address - Phone:540-613-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily