Provider Demographics
NPI:1598807661
Name:WAINRIGHT, REBECCA LOUISE (RN)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:LOUISE
Last Name:WAINRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 45013 BOX 2249
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-5013
Mailing Address - Country:US
Mailing Address - Phone:81046-407-4128
Mailing Address - Fax:
Practice Address - Street 1:1224 FAGIN DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-2209
Practice Address - Country:US
Practice Address - Phone:719-648-6934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1625183163WC0400X
TX535000261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORN.1625183OtherRN LICENSE
TX535000OtherNURSING LICENSE