Provider Demographics
NPI:1972235489
Name:STANDING ELK, REBECCA SARAH
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SARAH
Last Name:STANDING ELK
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:PO BOX 2061
Mailing Address - Street 2:
Mailing Address - City:FORT WASHAKIE
Mailing Address - State:WY
Mailing Address - Zip Code:82514-2061
Mailing Address - Country:US
Mailing Address - Phone:307-840-6827
Mailing Address - Fax:
Practice Address - Street 1:24 GREAT PLAINS ROAD
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:WY
Practice Address - Zip Code:82524-8252
Practice Address - Country:US
Practice Address - Phone:307-856-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist