Healthcare Provider Details

I. General information

NPI: 1760514632
Provider Name (Legal Business Name): REBECCA JEAN MASON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 N COTNER BLVD SUITE 1
LINCOLN NE
68505-1879
US

IV. Provider business mailing address

1221 N COTNER BLVD SUITE 1
LINCOLN NE
68505-1879
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-7283
  • Fax: 402-466-5387
Mailing address:
  • Phone: 402-466-7283
  • Fax: 402-466-5387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11611
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: