Provider Demographics
NPI:1346309598
Name:LOCKE, REBECCA KINGSBURY (RN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:KINGSBURY
Last Name:LOCKE
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 1:96 BURROWS HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2127
Mailing Address - Country:US
Mailing Address - Phone:585-330-6597
Mailing Address - Fax:
Practice Address - Street 1:14014 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-9301
Practice Address - Country:US
Practice Address - Phone:585-589-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY438122-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health