Healthcare Provider Details

I. General information

NPI: 1407263296
Provider Name (Legal Business Name): REBECCA ANN HEUER A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA ANN YAGER

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 N 18TH ST
MARYSVILLE KS
66508-1338
US

IV. Provider business mailing address

708 N 18TH ST
MARYSVILLE KS
66508-1338
US

V. Phone/Fax

Practice location:
  • Phone: 785-562-2311
  • Fax:
Mailing address:
  • Phone: 785-562-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76419
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: