Healthcare Provider Details

I. General information

NPI: 1780638072
Provider Name (Legal Business Name): REBECCA R WEST ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 E LINCOLNWAY
MORRISON IL
61270-2963
US

IV. Provider business mailing address

915 13TH AVE N
CLINTON IA
52732-5067
US

V. Phone/Fax

Practice location:
  • Phone: 815-772-7491
  • Fax: 815-772-7891
Mailing address:
  • Phone: 563-243-2511
  • Fax: 563-243-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209000539
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: