Provider Demographics
NPI:1568189306
Name:TROY, REBECCA MARIE STUART (EDD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE STUART
Last Name:TROY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 N 19TH AVE E
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-1131
Mailing Address - Country:US
Mailing Address - Phone:218-393-2423
Mailing Address - Fax:
Practice Address - Street 1:1304 N 19TH AVE E
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-1131
Practice Address - Country:US
Practice Address - Phone:218-393-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty