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NPI Code Detail

MEDICARE: REBECCA E MALOTT ACNP

MEDICARE: REBECCA E MALOTT ACNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerRN-300662OH
2363LA2100XAcute Care Nurse PractitionerNP-10005OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285894246
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA E MALOTT ACNP
Provider Business Mailing Address
First Line : 3170 KETTERING BLVD BLDG B2ND
Second Line :
City : MORAINE
State : OH
Zip : 45439-1924
Country : US
Telephone Number : 937-991-3188
Fax Number :
Provider Business Practice Location Address
First Line : 5275 STATE ROUTE 122 STE 200
Second Line :
City : FRANKLIN
State : OH
Zip : 45005-9617
Country : US
Telephone Number : 513-217-6400
Fax Number : 937-557-6435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2008
Last Update Date : 05/19/2025

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