Provider Demographics
NPI:1053558783
Name:STYLES, REBECCA D (MICROPIGMENTATION)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:STYLES
Suffix:
Gender:F
Credentials:MICROPIGMENTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1979
Mailing Address - Country:US
Mailing Address - Phone:865-218-6210
Mailing Address - Fax:865-218-6211
Practice Address - Street 1:10810 PARKSIDE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1979
Practice Address - Country:US
Practice Address - Phone:865-218-6210
Practice Address - Fax:865-218-6211
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5819080174400000X
TNELE0000000163246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No174400000XOther Service ProvidersSpecialist