Provider Demographics
NPI:1336488493
Name:CLARKIN, REBECCA LYNN (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:CLARKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20304 LORD RD
Mailing Address - Street 2:
Mailing Address - City:MERRIFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:56465-4180
Mailing Address - Country:US
Mailing Address - Phone:218-330-2218
Mailing Address - Fax:
Practice Address - Street 1:20304 LORD RD
Practice Address - Street 2:
Practice Address - City:MERRIFIELD
Practice Address - State:MN
Practice Address - Zip Code:56465-4180
Practice Address - Country:US
Practice Address - Phone:218-330-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-135802-3163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management