Healthcare Provider Details

I. General information

NPI: 1487332201
Provider Name (Legal Business Name): REBEKAH HERSHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7190 COLORADO BLVD STE 450
COMMERCE CITY CO
80022-1847
US

IV. Provider business mailing address

2351 PARK CENTRE DR APT 2-202
WESTMINSTER CO
80234-5644
US

V. Phone/Fax

Practice location:
  • Phone: 303-289-1086
  • Fax:
Mailing address:
  • Phone: 215-353-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number202325833
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: