Provider Demographics
NPI:1174600977
Name:ERVIN, REBECCA MURRAY (RNC, WHCNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MURRAY
Last Name:ERVIN
Suffix:
Gender:F
Credentials:RNC, WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 SUNNYVALE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-1733
Mailing Address - Country:US
Mailing Address - Phone:972-206-2359
Mailing Address - Fax:
Practice Address - Street 1:440 W LYNDON B JOHNSON FWY
Practice Address - Street 2:PLAZA II, SUITE 405
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3707
Practice Address - Country:US
Practice Address - Phone:972-869-0202
Practice Address - Fax:972-432-9903
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX571738363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health