Provider Demographics
NPI:1235752833
Name:BEKIBELE, RUEGBA
Entity Type:Individual
Prefix:
First Name:RUEGBA
Middle Name:
Last Name:BEKIBELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:PEDIATRICS EDUCATION OFFICE, M136, 1ST FLOOR, EAST BUIL
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-624-4477
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:PEDIATRICS EDUCATION OFFICE, M136, 1ST FLOOR, EAST BUIL
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-624-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2022-03-01
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-03-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program