Provider Demographics
NPI:1720523913
Name:REBELLO, NOELLA MARGARET (RN)
Entity type:Individual
Prefix:
First Name:NOELLA
Middle Name:MARGARET
Last Name:REBELLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 CONSOLIDATION AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2814
Mailing Address - Country:US
Mailing Address - Phone:360-961-7558
Mailing Address - Fax:
Practice Address - Street 1:4207 CONSOLIDATION AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2814
Practice Address - Country:US
Practice Address - Phone:360-961-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60644768163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse