=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396148136
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REBECCA RAPIER LPN
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2014
-----------------------------------------------------
Last Update Date | 10/08/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3637 HIESTAND RD
-----------------------------------------------------
City | ROSSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45362-9741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-621-4781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3637 HIESTAND RD
-----------------------------------------------------
City | ROSSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45362-9741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-621-4781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LPN
-----------------------------------------------------
Name | REBECCA SUE RAPIER
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 937-621-4781
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number | 138715
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------