Provider Demographics
NPI:1184846123
Name:BARBER-THOMAS, REBECCA OLUBUMI (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:OLUBUMI
Last Name:BARBER-THOMAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MR
Other - First Name:REBECCA
Other - Middle Name:OLUBUMI
Other - Last Name:BARBER-THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:4631 TREICHEL ST
Mailing Address - Street 2:4631 TREICHEL STREET
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-6933
Mailing Address - Country:US
Mailing Address - Phone:608-467-8265
Mailing Address - Fax:
Practice Address - Street 1:5696 CLAREDON DR
Practice Address - Street 2:5696 CLAREDON DR
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-6421
Practice Address - Country:US
Practice Address - Phone:608-288-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health