Provider Demographics
NPI:1306247317
Name:SUTTLE, REBECCA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SUTTLE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 7FL RM 7301F
Mailing Address - Street 2:619 19TH STREET SOUTH
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-7404
Mailing Address - Country:US
Mailing Address - Phone:205-975-5594
Mailing Address - Fax:
Practice Address - Street 1:176 7FL RM 7301F
Practice Address - Street 2:619 19TH STREET SOUTH
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-7404
Practice Address - Country:US
Practice Address - Phone:205-975-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127994363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology