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NPI Code Detail

MEDICARE: MRS. REBECCA MASSART NP

MEDICARE: MRS. REBECCA MASSART NP
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
1363L00000XNurse Practitioner2605-033WI
2363LW0102XWomen's Health Nurse Practitioner2605-033WI

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 : 1497815237
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA MASSART NP
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 1475 W GRAND AVE
Second Line :
City : PORT WASHINGTON
State : WI
Zip : 53074-2074
Country : US
Telephone Number : 262-268-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 10/07/2025

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