Healthcare Provider Details

I. General information

NPI: 1710890983
Provider Name (Legal Business Name): REBECCA SUE ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5776 US HIGHWAY 22 NW
RUSHVILLE OH
43150-9726
US

IV. Provider business mailing address

PO BOX 979
SOMERSET OH
43783-0979
US

V. Phone/Fax

Practice location:
  • Phone: 740-296-3120
  • Fax:
Mailing address:
  • Phone: 740-296-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042200
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: