Provider Demographics
NPI:1134643984
Name:SAROYAN, REBECCA (CNM)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:SAROYAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SHACKLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4439 STATE ROUTE 159 STE 120
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8207
Mailing Address - Country:US
Mailing Address - Phone:740-779-7201
Mailing Address - Fax:
Practice Address - Street 1:4439 STATE ROUTE 159 STE 120
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19340367A00000X
FLAPRN11022003367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife