Healthcare Provider Details

I. General information

NPI: 1548703622
Provider Name (Legal Business Name): REBECCA LEIGH BEJMA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2016
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BULLOCKS AVE
EAST PROVIDENCE RI
02915
US

IV. Provider business mailing address

100 BULLOCKS AVE
EAST PROVIDENCE RI
02915
US

V. Phone/Fax

Practice location:
  • Phone: 401-437-1008
  • Fax:
Mailing address:
  • Phone: 401-437-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN53395
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: