Provider Demographics
NPI:1124711924
Name:ZUNIGA, REBECCA NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:NICOLE
Last Name:ZUNIGA
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:NICOLE
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 12938
Mailing Address - Street 2:C/O CLINIC MANAGEMENT
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703
Mailing Address - Country:US
Mailing Address - Phone:706-602-7800
Mailing Address - Fax:
Practice Address - Street 1:7 JOHN MADDOX DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1413
Practice Address - Country:US
Practice Address - Phone:706-368-8500
Practice Address - Fax:706-307-4613
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11636363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant