Provider Demographics
NPI:1194949834
Name:MESTAS, REBECCA DENISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DENISE
Last Name:MESTAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:DENISE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3438 STARBOARD LN
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-7617
Mailing Address - Country:US
Mailing Address - Phone:907-770-7515
Mailing Address - Fax:907-334-8587
Practice Address - Street 1:3101 PENLAND PKWY
Practice Address - Street 2:SUITE J-11
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1906
Practice Address - Country:US
Practice Address - Phone:907-279-8055
Practice Address - Fax:907-334-8587
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1612183500000X
MD16711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist