Healthcare Provider Details

I. General information

NPI: 1295642056
Provider Name (Legal Business Name): REBECCA JOY WORRALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CANDLETREE LN APT 69
LINCOLN NE
68506-1741
US

IV. Provider business mailing address

7200 CANDLETREE LN APT 69
LINCOLN NE
68506-1741
US

V. Phone/Fax

Practice location:
  • Phone: 402-600-9877
  • Fax:
Mailing address:
  • Phone: 402-600-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: