Healthcare Provider Details

I. General information

NPI: 1922663244
Provider Name (Legal Business Name): SARAH REBEL NPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 WEBSTER ST
HANOVER MA
02339-1200
US

IV. Provider business mailing address

190 OLD DERBY ST STE 211
HINGHAM MA
02043-4066
US

V. Phone/Fax

Practice location:
  • Phone: 781-429-7755
  • Fax:
Mailing address:
  • Phone: 781-214-1844
  • Fax: 781-350-9572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2388066
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number403520
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2388066
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number743920
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: