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General NPI Number Information
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NPI Number | 1528883832
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Entity Type | Individual
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Provider Name | REBEKAH LILLIAN VANCE DNP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 423 W PINE ST
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City | PINEDALE
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State | WY
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Zip | 82941-5317
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Country | US
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Telephone | 307-367-7647
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1781
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City | PINEDALE
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State | WY
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Zip | 82941-1781
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Country | US
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Telephone | 307-231-6400
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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 | 55325
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 55325
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 55325
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 55325
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License Number State | WY
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 55325
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License Number State | WY
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 55325
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License Number State | WY
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Taxonomy #7
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 55325
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License Number State | WY
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 55325
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License Number State | WY
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