Provider Demographics
NPI:1225308133
Name:SOLIS, REBEKAH E (RN,MSN,FNPBC)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:E
Last Name:SOLIS
Suffix:
Gender:F
Credentials:RN,MSN,FNPBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:337-991-9276
Mailing Address - Fax:337-943-0846
Practice Address - Street 1:1602 ROCK PRAIRIE RD STE 300
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8309
Practice Address - Country:US
Practice Address - Phone:979-693-7400
Practice Address - Fax:979-695-3423
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638655363L00000X
TXAP117582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX638655OtherRN LIC #