Healthcare Provider Details

I. General information

NPI: 1093634263
Provider Name (Legal Business Name): REBECCA ROCKEFELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA FREAR

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 W FAIDLEY AVE STE 2100
GRAND ISLAND NE
68803-4602
US

IV. Provider business mailing address

2610 S ENGLEMAN RD
ALDA NE
68810-9722
US

V. Phone/Fax

Practice location:
  • Phone: 308-382-4297
  • Fax:
Mailing address:
  • Phone: 402-705-6922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number117081
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: