Provider Demographics
NPI:1043336670
Name:HALE, REBECCA RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:RENEE
Last Name:HALE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:RENEE
Other - Last Name:HALE-BERTHEOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:43850 CRISPEN RD
Mailing Address - City:MANCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:95459-0291
Mailing Address - Country:US
Mailing Address - Phone:707-882-2939
Mailing Address - Fax:
Practice Address - Street 1:275 HOSPITAL DR
Practice Address - Street 2:UKIAH VALLEY MEDICAL HOSPITAL
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482
Practice Address - Country:US
Practice Address - Phone:707-462-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA517490163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse