Healthcare Provider Details

I. General information

NPI: 1487586228
Provider Name (Legal Business Name): REBECCA MCCABE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E GROVE ST
OREGON WI
53575-1454
US

IV. Provider business mailing address

123 E GROVE ST
OREGON WI
53575-1454
US

V. Phone/Fax

Practice location:
  • Phone: 608-835-4109
  • Fax:
Mailing address:
  • Phone: 608-835-4109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number132806-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: