Provider Demographics
NPI:1578831590
Name:ELQUIST, REBECCA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LOUISE
Last Name:ELQUIST
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 1:1721 MEADOWVALE WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-2947
Mailing Address - Country:US
Mailing Address - Phone:775-358-8945
Mailing Address - Fax:775-358-8945
Practice Address - Street 1:1721 MEADOWVALE WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-2947
Practice Address - Country:US
Practice Address - Phone:775-358-8945
Practice Address - Fax:775-358-8945
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner