Provider Demographics
NPI:1609446962
Name:SCHMITZ, REBEKAH ANNE
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ANNE
Last Name:SCHMITZ
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 1:617 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:AR
Mailing Address - Zip Code:72933-9231
Mailing Address - Country:US
Mailing Address - Phone:479-275-9477
Mailing Address - Fax:
Practice Address - Street 1:3010 HIGHWAY 22 E STE A
Practice Address - Street 2:
Practice Address - City:BRANCH
Practice Address - State:AR
Practice Address - Zip Code:72928-9648
Practice Address - Country:US
Practice Address - Phone:479-965-3063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program