Provider Demographics
NPI:1144768821
Name:LABOUFF, REBEKAH J (APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:J
Last Name:LABOUFF
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 S YALE AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7805
Mailing Address - Country:US
Mailing Address - Phone:918-493-3300
Mailing Address - Fax:918-493-3315
Practice Address - Street 1:6465 S YALE AVE STE 320
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7805
Practice Address - Country:US
Practice Address - Phone:918-493-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK102805363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics