MEDICARE: REBECKA LINDBERG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	P57933	IA

General Provider Information

NPI Number	:	1407306160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECKA LINDBERG

Provider Business Mailing Address
First Line	:	403 SE C AVE
Second Line	:	P.O. BOX 54
City	:	GILMORE CITY
State	:	IA
Zip	:	50541-8798
Country	:	US
Telephone Number	:	515-369-2293
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 SE C AVE
Second Line	:
City	:	GILMORE CITY
State	:	IA
Zip	:	50541-8798
Country	:	US
Telephone Number	:	515-368-2293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	10/06/2016

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Directions to “ REBECKA LINDBERG ” Practice Location

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