MEDICARE: REBEKAH ROBINSON

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	163W00000X	Registered Nurse	14-121952-022	KS
2	363LF0000X	Family Nurse Practitioner	TMP147584	KS

General Provider Information

NPI Number	:	1942632435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH ROBINSON

Provider Business Mailing Address
First Line	:	106 W 11TH ST
Second Line	:	SUITE 1215
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-1813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 W 11TH ST
Second Line	:	SUITE 1215
City	:	KANSAS CITY
State	:	MO
Zip	:	64105-1813
Country	:	US
Telephone Number	:	816-822-0050
Fax Number	:	816-817-0000

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

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	09/09/2013

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Directions to “ REBEKAH ROBINSON ” Practice Location

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