Healthcare Provider Details

I. General information

NPI: 1033523410
Provider Name (Legal Business Name): REBECCA REPSTINE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 06/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 W ALAMEDA AVE
LAKEWOOD CO
80226-3007
US

IV. Provider business mailing address

2445 S XANADU WAY UNIT A
AURORA CO
80014-2128
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 720-747-9478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN0122149
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: