Provider Demographics
NPI:1376036954
Name:PIERCE, REBEKAH ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ELIZABETH
Last Name:PIERCE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 N JEFFERSON AVE STE K500
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-1988
Mailing Address - Country:US
Mailing Address - Phone:417-269-3813
Mailing Address - Fax:417-269-3817
Practice Address - Street 1:1423 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-1988
Practice Address - Country:US
Practice Address - Phone:417-269-3813
Practice Address - Fax:417-269-3817
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006024994363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care