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General NPI Number Information
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NPI Number | 1841036142
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Entity Type | Individual
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Provider Name | REBECCA JO REYES AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/05/2024
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 4701 TOWNE CENTRE RD STE 201
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City | SAGINAW
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State | MI
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Zip | 48604-2833
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Country | US
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Telephone | 989-792-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 N STATE ST
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City | SAINT IGNACE
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State | MI
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Zip | 49781-1048
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Country | US
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Telephone | 231-436-9900
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4704293265
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 4704293265
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License Number State | MI
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