Provider Demographics
NPI:1104185065
Name:KRZYMINSKI, REBECCA A (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:KRZYMINSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:MOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1333 W 5TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2752
Mailing Address - Country:US
Mailing Address - Phone:307-672-2522
Mailing Address - Fax:307-675-3732
Practice Address - Street 1:1333 W 5TH ST STE 210
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2700
Practice Address - Country:US
Practice Address - Phone:307-672-2522
Practice Address - Fax:307-672-3732
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019698207V00000X
TNDO3081207V00000X
WY15200A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology