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General NPI Number Information
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NPI Number | 1962888677
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Entity Type | Individual
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Provider Name | REBECCA ELLEN WAUGH MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 5450 E 425 N
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City | MEDARYVILLE
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State | IN
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Zip | 47957-8514
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Country | US
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Telephone | 574-603-0067
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Fax | 574-205-9259
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Provider Business Mailing Address
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Address Line | 5450 E 425 N
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City | MEDARYVILLE
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State | IN
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Zip | 47957-8514
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Country | US
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Telephone | 574-603-0067
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4049695
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71005656A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 28138946A
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License Number State | IN
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