Provider Demographics
NPI:1922970300
Name:WOLF, REBECCA KAY
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KAY
Last Name:WOLF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E PHILIP AVE TRLR 23C
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6686
Mailing Address - Country:US
Mailing Address - Phone:308-252-1022
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 939
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-0939
Practice Address - Country:US
Practice Address - Phone:308-252-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion