Provider Demographics
NPI:1679512420
Name:HARPOLD, REBECCA B (RN, MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:B
Last Name:HARPOLD
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:B
Other - Last Name:CHEATWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MSN,FNP
Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-855-5002
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-855-5002
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164867363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily