Provider Demographics
NPI:1568026375
Name:NATION, REBECCA KATHERINE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KATHERINE
Last Name:NATION
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 KING ARTHUR BLVD APT 5
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2468
Mailing Address - Country:US
Mailing Address - Phone:618-610-2818
Mailing Address - Fax:
Practice Address - Street 1:1 N STADIUM RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802
Practice Address - Country:US
Practice Address - Phone:225-578-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL20000345322255A2300X
LA3281982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2000034532OtherBOC