Provider Demographics
NPI:1598958555
Name:VANDEWATER, REBECCA MARIE (APRN, CNM)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:MARIE
Last Name:VANDEWATER
Suffix:
Gender:F
Credentials:APRN, CNM
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Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:SOUTH EGREMONT
Mailing Address - State:MA
Mailing Address - Zip Code:01258-0006
Mailing Address - Country:US
Mailing Address - Phone:907-957-6597
Mailing Address - Fax:833-689-9875
Practice Address - Street 1:1601 SALMON CREEK LN
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7867
Practice Address - Country:US
Practice Address - Phone:907-957-6597
Practice Address - Fax:833-689-9875
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2022-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK983367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife