National Provider Identifier
Rebecca Susan Pettibone, NP
Rebecca Susan Pettibone, NP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 734-7121.
Profile Overview
- NPI
- 1205574316
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- May 27, 2022
- Last Updated
- May 27, 2022
Practice Location
- 555 Saint Josephs Blvd Ste M2
- Elmira, NY 14901-3223
Phone: (607) 734-7121
Mailing Address
- 571 Saint Josephs Blvd Fl 2
- Elmira, NY 14901-3230
Specialties
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1205574316
- Entity Type
- Individual
- Last Name
- Pettibone
- First Name
- Rebecca
- Middle Name
- Susan
- Credential
- NP
- Mailing Street Address
- 571 Saint Josephs Blvd Fl 2
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Mailing Phone
- (607) 271-2050
- Mailing Fax
- (607) 873-1244
- Practice Street Address
- 555 Saint Josephs Blvd Ste M2
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-3223
- Practice Country
- US
- Practice Phone
- (607) 734-7121
- Practice Fax
- (607) 734-0614
- Enumeration Date
- May 27, 2022
- Last Updated
- May 27, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 27, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X)