MEDICARE: MS. REBECCA JANE HULEM N.P.

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	163WW0101X	Ambulatory Women's Health Care Registered Nurse	269076	CA

General Provider Information

NPI Number	:	1932364718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA JANE HULEM N.P.

Provider Business Mailing Address
First Line	:	5737 KANAN RD
Second Line	:	SUITE 261
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1601
Country	:	US
Telephone Number	:	818-425-2886
Fax Number	:

Provider Business Practice Location Address
First Line	:	5737 KANAN RD
Second Line	:	SUITE 261
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1601
Country	:	US
Telephone Number	:	818-425-2886
Fax Number	:

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

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	07/22/2008

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