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General NPI Number Information
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NPI Number | 1124045141
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Entity Type | Individual
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Provider Name | REBECCA RUTH NOVAK FNP
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 50 BUCK CREEK RD STE 100
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City | AVON
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State | CO
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Zip | 81620-5428
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Country | US
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Telephone | 970-945-2840
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Fax | 970-945-2893
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Provider Business Mailing Address
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Address Line | PO BOX 842578
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City | KANSAS CITY
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State | MO
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Zip | 64184-2578
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Country | US
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Telephone | 970-926-6350
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Fax | 970-926-6348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN000634
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9308
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0991938
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0991938-NP
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License Number State | CO
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