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NPI Code Detail

MEDICARE: REBEKAH MILLER RN

MEDICARE:   REBEKAH  MILLER  RN
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
1163W00000XRegistered Nurse155155WI

General Provider Information

NPI Number : 1740011055
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH MILLER RN
Provider Business Mailing Address
First Line : 5506 85TH ST
Second Line :
City : PLEASANT PRAIRIE
State : WI
Zip : 53158-3203
Country : US
Telephone Number : 262-496-9536
Fax Number :
Provider Business Practice Location Address
First Line : 5506 85TH ST
Second Line :
City : PLEASANT PRAIRIE
State : WI
Zip : 53158-3203
Country : US
Telephone Number : 262-496-9536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2024
Last Update Date : 08/08/2024

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