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General NPI Number Information
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NPI Number | 1366222556
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Entity Type | Individual
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Provider Name | REBECCA GRACE HANDLEY
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 703 MAIN ST
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City | DUBUQUE
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State | IA
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Zip | 52001-6814
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Country | US
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Telephone | 563-588-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 9411 MODERN POINT LN APT 302
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City | VERONA
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State | WI
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Zip | 53593-9098
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Country | US
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Telephone | 507-951-7468
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24790
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22308-40
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License Number State | WI
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