Provider Demographics
NPI:1962268094
Name:STEVENS, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEVENS
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 1:510 BARTON ST
Mailing Address - Street 2:
Mailing Address - City:STRATTON
Mailing Address - State:NE
Mailing Address - Zip Code:69043-5106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 BARTON ST
Practice Address - Street 2:
Practice Address - City:STRATTON
Practice Address - State:NE
Practice Address - Zip Code:69043-5106
Practice Address - Country:US
Practice Address - Phone:308-737-8582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)