Provider Demographics
NPI:1558459867
Name:NESS, REBECCA JANE (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:NESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2401 DEMERS AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-780-1891
Mailing Address - Fax:701-780-4477
Practice Address - Street 1:1300 S COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-780-5000
Practice Address - Fax:701-780-4477
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND1042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND50900Medicaid
MN520213200Medicaid
2476885OtherUNITED HEALTH CARE
64-06866OtherMEDICA
01042277OtherPREFERRED ONE
115081OtherHEALTH PARTNERS
ND27395OtherBLUE CROSS/BLUE SHIELD
MN459L0NEOtherBC/BS
ND51346Medicaid
ND51346Medicaid