REBECCA B HARTZOG (NPI# 1215267018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215267018 |
| Entity Type | Individual |
| Full Name | REBECCA B HARTZOG |
| Other Name | REBECCA A BURRIS |
| Credential | PMHNP |
| Practice Address |
1 Lincoln Pkwy Ste 304 Hattiesburg MS 39402-3261 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012611750 |
| Practice Fax Number | 6012611755 |
| Mailing Telephone | 6012615159 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R876189 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04973557 | 05 |
| Street Address |
1 LINCOLN PKWY STE 304 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275186850 | Erika Lytice Newsome | Nurse Practitioner | 1 Lincoln Pkwy Ste 304, Hattiesburg, MS 39402-3261 | 2019-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679624696 | Diann Branton Mayfield | Nurse Practitioner | 2 Southern Point Pkwy, Suite 200, Hattiesburg, MS 39401-8025 | 2007-01-16 |
| 1275186850 | Erika Lytice Newsome | Nurse Practitioner | 1 Lincoln Pkwy Ste 304, Hattiesburg, MS 39402-3261 | 2019-07-22 |
| 1679084024 | Donald Allan Dearman | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-10-12 |
| 1538693510 | William Smith Turner Jr. | Nurse Practitioner | 2255 Broadway Dr, Hattiesburg, MS 39402-3254 | 2017-04-17 |
| 1174068076 | Racheal Marie Pritchett | Nurse Practitioner | 101 Aldersgate Cir, Hattiesburg, MS 39402-1301 | 2016-12-31 |
| 1346691714 | Billy J Thornton | Nurse Practitioner | 1 Lincoln Pkwy, Suite 202, Hattiesburg, MS 39402-3262 | 2016-06-28 |
| 1386930477 | Karen Lee | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2011-06-27 |
| 1093722662 | Sandra Kinnan | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2006-08-03 |
| 1346284130 | Patricia Calabrese | Nurse Practitioner | 1 Lincoln Parkway, Suite 202, Hattiesburg, MS 39402 | 2006-06-15 |
| 1194768242 | Richard Wayne George | Nurse Practitioner | 1 Lincoln Parkway, Suite 202, Hattiesburg, MS 39402 | 2006-06-14 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
Please comment or provide details below to improve the information on REBECCA B HARTZOG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.