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General NPI Number Information
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NPI Number | 1326311663
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Entity Type | Individual
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Provider Name | REBECCA SUSAN FLACK RN, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 12188A N MERIDIAN ST STE 200
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City | CARMEL
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State | IN
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Zip | 46032-4410
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Country | US
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Telephone | 317-957-9510
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28157385A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 84000070A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT20901811
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License Number State | IN
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