Provider Demographics
NPI:1518160290
Name:SPENCER, REBECCA ANNE
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANNE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14268 CASTELAR PLZ APT 13
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2228
Mailing Address - Country:US
Mailing Address - Phone:402-592-5244
Mailing Address - Fax:402-529-2501
Practice Address - Street 1:11134 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3609
Practice Address - Country:US
Practice Address - Phone:402-592-5244
Practice Address - Fax:402-592-2501
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician