REBEL NEUROMONITORING LLC NPI 1871005892

NPI Information

  • NPI: 1871005892
  • Provider Name: REBEL NEUROMONITORING, LLC
  • Classification: Psychiatry & Neurology - 2084N0600X
  • Specialization: Clinical Neurophysiology
  • Entity Type: Organization
  • Address: 205 SOUTH 40TH AVE
    HATTIESBURG, MS
    ZIP 39402
  • Phone: (210) 598-4277

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NPI Details

REBEL NEUROMONITORING, LLC is a clinical neurophysiology psychiatry neurology in Hattiesburg, MS. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). REBEL NEUROMONITORING, LLC NPI is 1871005892. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

205 SOUTH 40TH AVE
HATTIESBURG, MS
ZIP 39402
Phone: (210) 598-4277

The provider's authorized official is Roxanna Laroque .
The authorized official title is Director Of Client Experience and has the following contact phone number (210) 598-4277.

The enumeration date for this NPI number is 10/31/2017 and was last updated on 8/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204R00000XElectrodiagnostic MedicineNo
22084N0400XPsychiatry & NeurologyNeurologyNo
3246ZE0600XSpecialist/Technologist, OtherElectroneurodiagnosticNo
42084N0600XPsychiatry & NeurologyClinical NeurophysiologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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