Provider Demographics
NPI:1194422584
Name:CLOUSE, REBECCA RAE (FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RAE
Last Name:CLOUSE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:CLOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:610 GLOVER RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-3049
Mailing Address - Country:US
Mailing Address - Phone:308-254-4752
Mailing Address - Fax:
Practice Address - Street 1:610 GLOVER RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-3049
Practice Address - Country:US
Practice Address - Phone:308-254-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily