Provider Demographics
NPI:1699121434
Name:MEEHAN, REBECCA RENEE (RN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:RENEE
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:RENEE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:39 LINDEN AVE.
Mailing Address - Street 2:(COOPERSTOWN CENTRAL SCHOOL)
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326
Mailing Address - Country:US
Mailing Address - Phone:607-547-8181
Mailing Address - Fax:607-547-5100
Practice Address - Street 1:39 LINDEN AVE.
Practice Address - Street 2:(COOPERSTOWN CENTRAL SCHOOL)
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326
Practice Address - Country:US
Practice Address - Phone:607-547-8181
Practice Address - Fax:607-547-5100
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY518825-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool