Provider Demographics
NPI:1154051571
Name:NOLES, REBECCA MARIE (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:NOLES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4800 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6004
Mailing Address - Country:US
Mailing Address - Phone:904-398-7205
Mailing Address - Fax:
Practice Address - Street 1:150 LONGLEAF PINE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-7529
Practice Address - Country:US
Practice Address - Phone:904-652-0800
Practice Address - Fax:904-652-0811
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020006363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily