Provider Demographics
NPI:1720543218
Name:PAFFENROTH, REBECCA L (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:PAFFENROTH
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Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2579 HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1451
Mailing Address - Country:US
Mailing Address - Phone:770-487-2645
Mailing Address - Fax:678-273-7218
Practice Address - Street 1:2579 HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1451
Practice Address - Country:US
Practice Address - Phone:770-487-2645
Practice Address - Fax:678-273-7218
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001090363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health