Provider Demographics
NPI:1386865004
Name:ALLEN, REBEKAH JOHANNAH (RN, FNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JOHANNAH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15124
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-5124
Mailing Address - Country:US
Mailing Address - Phone:480-998-4673
Mailing Address - Fax:
Practice Address - Street 1:8181 S 48TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5309
Practice Address - Country:US
Practice Address - Phone:602-448-6660
Practice Address - Fax:602-894-1446
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily