Healthcare Provider Details

I. General information

NPI: 1871406694
Provider Name (Legal Business Name): REBECCA LOU NALE BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 SOUTHPARK CT
COLUMBUS IN
47201-7489
US

IV. Provider business mailing address

1455 NE MAIN ST
PAOLI IN
47454-9712
US

V. Phone/Fax

Practice location:
  • Phone: 812-803-2673
  • Fax: 930-220-7104
Mailing address:
  • Phone: 812-803-2673
  • Fax: 930-220-7104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: