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NPI Code Detail

MEDICARE: MRS. REBECCA THROOP LENDERMAN C-NP

MEDICARE: MRS. REBECCA THROOP LENDERMAN C-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
1163WC0200XCritical Care Medicine Registered Nurse2006007367MO
2363LF0000XFamily Nurse Practitioner2016003662MO

General Provider Information

NPI Number : 1841658523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA THROOP LENDERMAN C-NP
Provider Business Mailing Address
First Line : 102 HOSPITALITY DR
Second Line :
City : SIKESTON
State : MO
Zip : 63801-9382
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-471-7559
Provider Business Practice Location Address
First Line : 102 HOSPITALITY DR
Second Line :
City : SIKESTON
State : MO
Zip : 63801-9382
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-471-7559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2016
Last Update Date : 03/07/2022

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