Provider Demographics
NPI:1619993748
Name:ANGERSTEIN, REBECCA L (CNS, FAHA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:ANGERSTEIN
Suffix:
Gender:F
Credentials:CNS, FAHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W CEDAR ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2400
Mailing Address - Country:US
Mailing Address - Phone:330-376-0500
Mailing Address - Fax:330-376-9900
Practice Address - Street 1:185 W CEDAR ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2400
Practice Address - Country:US
Practice Address - Phone:330-376-0500
Practice Address - Fax:330-376-9900
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS04550364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2513177Medicaid
OH2513177Medicaid
OHNS01074Medicare PIN