Healthcare Provider Details

I. General information

NPI: 1851802722
Provider Name (Legal Business Name): REBECCAH C SARGENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SARGENT DR
FREDERICKTOWN MO
63645-7526
US

IV. Provider business mailing address

925 HIGHWAY VV
KENNETT MO
63857
US

V. Phone/Fax

Practice location:
  • Phone: 573-783-4400
  • Fax:
Mailing address:
  • Phone: 573-888-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2026045520
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: