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NPI Code Detail

MEDICARE: REBECA KISER RN

MEDICARE: REBECA KISER RN
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
1163WS0200XSchool Registered Nurse717291NY

General Provider Information

NPI Number : 1699549212
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECA KISER RN
Provider Business Mailing Address
First Line : 7263 MAIN ST
Second Line :
City : OVID
State : NY
Zip : 14521-9586
Country : US
Telephone Number : 607-869-9636
Fax Number :
Provider Business Practice Location Address
First Line : 7263 MAIN ST
Second Line :
City : OVID
State : NY
Zip : 14521-9586
Country : US
Telephone Number : 607-869-9636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2023
Last Update Date : 11/14/2023

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