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NPI Code Detail

MEDICARE: MRS. REBECCA LYNN WHITED C.R.N.A.

MEDICARE: MRS. REBECCA LYNN WHITED C.R.N.A.
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
1367500000XCertified Registered Nurse Anesthetist0024164382VA

General Provider Information

NPI Number : 1639138068
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA LYNN WHITED C.R.N.A.
Provider Business Mailing Address
First Line : 602 ARBROATH RD
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-5104
Country : US
Telephone Number : 434-572-9312
Fax Number :
Provider Business Practice Location Address
First Line : 142 S MAIN ST
Second Line :
City : DANVILLE
State : VA
Zip : 24541-2922
Country : US
Telephone Number : 434-799-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 07/03/2013

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