Provider Demographics
NPI:1174859342
Name:PFLUGHOEFT, REBECCA E (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:PFLUGHOEFT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 E WALL ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:WI
Mailing Address - Zip Code:54521-9368
Mailing Address - Country:US
Mailing Address - Phone:715-477-3000
Mailing Address - Fax:715-477-3100
Practice Address - Street 1:930 E WALL ST
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:WI
Practice Address - Zip Code:54521-9368
Practice Address - Country:US
Practice Address - Phone:715-477-3000
Practice Address - Fax:715-477-3100
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5015-33363LF0000X, 363LP2300X
WI101293-030163W00000X
WI501533363LF0000X, 363LP2300X
MI4704122828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FO812263OtherAANP