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NPI Code Detail

MEDICARE: MARISA REBEKA NP

MEDICARE: MARISA REBEKA NP
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
1163W00000XRegistered NurseRN164040AZ
2363L00000XNurse PractitionerAP7413AZ

General Provider Information

NPI Number : 1588066013
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISA REBEKA NP
Provider Business Mailing Address
First Line : 8125 N HAYDEN RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-2463
Country : US
Telephone Number : 480-587-5054
Fax Number : 480-882-5809
Provider Business Practice Location Address
First Line : 9250 N 3RD ST STE 2015
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-2404
Country : US
Telephone Number : 602-786-0030
Fax Number : 808-825-8864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2014
Last Update Date : 03/13/2025

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