Provider Demographics
NPI:1588783609
Name:CHURCHMAN, REBECCA LEA (RN, CRNFA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEA
Last Name:CHURCHMAN
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 ASH MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2203
Mailing Address - Country:US
Mailing Address - Phone:281-537-1618
Mailing Address - Fax:
Practice Address - Street 1:800 PEAKWOOD DR STE 8B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2904
Practice Address - Country:US
Practice Address - Phone:281-580-6797
Practice Address - Fax:281-580-6693
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX462655163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX462655OtherLICENSED PROFESSIONAL RN