Healthcare Provider Details

I. General information

NPI: 1497963318
Provider Name (Legal Business Name): JAN LORRAINE RABE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAN LORRAINE RABE IV R.N.

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9915 SANDIFUR PKWY
PASCO WA
99301-8941
US

IV. Provider business mailing address

5220 W 10TH AVE
KENNEWICK WA
99336-9303
US

V. Phone/Fax

Practice location:
  • Phone: 509-546-2222
  • Fax: 509-546-2202
Mailing address:
  • Phone: 509-735-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN00090480
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: