Healthcare Provider Details

I. General information

NPI: 1609708627
Provider Name (Legal Business Name): REBECCA LINDLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W UNIVERSITY BLVD
DURANT OK
74701-3006
US

IV. Provider business mailing address

1525 IRVING ST
LINCOLN NE
68521-1939
US

V. Phone/Fax

Practice location:
  • Phone: 580-924-3080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: