Provider Demographics
NPI:1386913473
Name:STEWART, REBECCA J'LIN (FNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:J'LIN
Last Name:STEWART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1314
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:3801 50TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-3807
Practice Address - Country:US
Practice Address - Phone:806-725-7700
Practice Address - Fax:806-725-7701
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX631038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily