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NPI Code Detail

MEDICARE: MRS. REBECCA LYNN AL-HAMDANI NP-C

MEDICARE: MRS. REBECCA LYNN AL-HAMDANI NP-C
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
1363LF0000XFamily Nurse PractitionerRN.347025OH

General Provider Information

NPI Number : 1407113442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA LYNN AL-HAMDANI NP-C
Provider Business Mailing Address
First Line : 30 E APPLE ST
Second Line : NW 3300
City : DAYTON
State : OH
Zip : 45409-2939
Country : US
Telephone Number : 937-208-8394
Fax Number : 937-208-8388
Provider Business Practice Location Address
First Line : 136 S LUDLOW ST
Second Line : FL.1
City : DAYTON
State : OH
Zip : 45402-1813
Country : US
Telephone Number : 937-499-8273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2012
Last Update Date : 11/04/2015

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