Healthcare Provider Details

I. General information

NPI: 1285384321
Provider Name (Legal Business Name): REBECCAH LINDSEY TOVAR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCAH LINDSEY STANSBERY

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 E SOUTHERN AVE
TEMPE AZ
85282-7649
US

IV. Provider business mailing address

1144 65TH ST STE F
OAKLAND CA
94608-1053
US

V. Phone/Fax

Practice location:
  • Phone: 623-624-8280
  • Fax: 602-835-0192
Mailing address:
  • Phone: 510-929-1400
  • Fax: 510-929-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95248952
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95020127
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number288965
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: