Provider Demographics
NPI:1972174225
Name:OLLMAN, REBECCA (LPN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:OLLMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1387
Mailing Address - Country:US
Mailing Address - Phone:812-537-5700
Mailing Address - Fax:812-537-5701
Practice Address - Street 1:181 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1387
Practice Address - Country:US
Practice Address - Phone:812-537-5700
Practice Address - Fax:812-537-5701
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27070831A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse