Provider Demographics
NPI:1851186597
Name:SHONKWILER, REBECCA LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:SHONKWILER
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4788
Mailing Address - Country:US
Mailing Address - Phone:740-370-4234
Mailing Address - Fax:
Practice Address - Street 1:621 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4788
Practice Address - Country:US
Practice Address - Phone:740-370-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0038744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily