Provider Demographics
NPI:1164814851
Name:VEGA, REBEKAH J (FNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:J
Last Name:VEGA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 W LINCOLN HWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1098
Mailing Address - Country:US
Mailing Address - Phone:219-769-1362
Mailing Address - Fax:219-836-1072
Practice Address - Street 1:5521 W LINCOLN HWY STE 1A
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307
Practice Address - Country:US
Practice Address - Phone:219-769-1362
Practice Address - Fax:219-836-1072
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28164474A163W00000X
IN71005374B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse