Healthcare Provider Details

I. General information

NPI: 1649160946
Provider Name (Legal Business Name): REBEKAH MAY HENDERSON RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 US HIGHWAY 395 N
GARDNERVILLE NV
89410-5304
US

IV. Provider business mailing address

6195 SHETLAND ST
STAGECOACH NV
89429-9108
US

V. Phone/Fax

Practice location:
  • Phone: 775-182-1500
  • Fax:
Mailing address:
  • Phone: 916-390-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number821309
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: