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General NPI Number Information
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NPI Number | 1205566981
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Entity Type | Individual
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Provider Name | REBECCA RANDELL ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 3016 E 57TH AVE STE 27
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City | SPOKANE
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State | WA
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Zip | 99223-7036
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Country | US
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Telephone | 509-724-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 4206 S MARTIN ST
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City | SPOKANE
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State | WA
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Zip | 99203-4233
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Country | US
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Telephone | 801-450-3021
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP61320193
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60725666
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License Number State | WA
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