Provider Demographics
NPI:1477189678
Name:CAUDILL, REBECCA LYNN (RRT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:CAUDILL
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:SULKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT
Mailing Address - Street 1:54 SHEEP CAMP RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-9629
Mailing Address - Country:US
Mailing Address - Phone:513-288-4774
Mailing Address - Fax:
Practice Address - Street 1:54 SHEEP CAMP RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-9629
Practice Address - Country:US
Practice Address - Phone:513-288-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6778227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered