Provider Demographics
NPI:1629382130
Name:HONEYCUTT, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 UPCHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DUBACH
Mailing Address - State:LA
Mailing Address - Zip Code:71235-2558
Mailing Address - Country:US
Mailing Address - Phone:318-577-0579
Mailing Address - Fax:
Practice Address - Street 1:253 UPCHURCH RD
Practice Address - Street 2:
Practice Address - City:DUBACH
Practice Address - State:LA
Practice Address - Zip Code:71235-2558
Practice Address - Country:US
Practice Address - Phone:318-577-0579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
LA310822176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
18060012OtherNORTH AMERICAN REGISTRY OF MIDWIVES
LA310822OtherLOUISIANA BOARD OF MEDICAL EXAMINERS