Provider Demographics
NPI:1346439353
Name:RIEGEL, REBECCA GENDRON (RN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:GENDRON
Last Name:RIEGEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6401 YORK ROAD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2130
Mailing Address - Country:US
Mailing Address - Phone:410-887-3485
Mailing Address - Fax:410-377-8296
Practice Address - Street 1:6401 YORK ROAD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2130
Practice Address - Country:US
Practice Address - Phone:410-887-3485
Practice Address - Fax:410-377-8296
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR130625163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health