Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rebecca Theresa Medlock, AGACNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1023632932

Rebecca Theresa Medlock, AGACNP-BC is a Gerontology Nurse Practitioner in Fenton, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2020
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Practice location Address checks out

736 Marco Valley Ct
Fenton, MO 63026-5318
Phone: (314) 413-2187
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 2019029631 (MO)

Record details

NPI number1023632932
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedJune 5, 2020
Last updated in NPPESSeptember 11, 2025
Certification dateJuly 8, 2020

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