Provider Demographics
NPI:1902504111
Name:THARP, REBECCA M (DNP, FNP-C, APRN)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:M
Last Name:THARP
Suffix:
Gender:F
Credentials:DNP, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 VENTURE WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4353
Mailing Address - Country:US
Mailing Address - Phone:307-268-9904
Mailing Address - Fax:307-298-6294
Practice Address - Street 1:1300 VENTURE WAY STE 206
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4353
Practice Address - Country:US
Practice Address - Phone:307-268-9904
Practice Address - Fax:307-298-6294
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY51552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily