Provider Demographics
NPI:1578577532
Name:ADAMSON, REBECCA JANE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JANE
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2007 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-3571
Mailing Address - Country:US
Mailing Address - Phone:620-704-0239
Mailing Address - Fax:620-232-1609
Practice Address - Street 1:410 E ATKINSON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-2342
Practice Address - Country:US
Practice Address - Phone:320-231-3200
Practice Address - Fax:620-235-7134
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100380540-CMedicaid
KSP21727Medicare UPIN