Basic Information
Provider Information
NPI: 1932514908
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMLIN
FirstName: REBECCA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1545 9TH ST SW
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329624312
CountryCode: US
TelephoneNumber: 7225782247
FaxNumber: 7722133157
Practice Location
Address1: 787 37TH ST STE 140
Address2:  
City: VERO BEACH
State: FL
PostalCode: 329607305
CountryCode: US
TelephoneNumber: 7722578224
FaxNumber: 7221331577
Other Information
ProviderEnumerationDate: 06/27/2014
LastUpdateDate: 01/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN9458339FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
APRN945833901FLSTATE LICENSEOTHER


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