Provider Demographics
NPI:1629113048
Name:REHKOPF, CARRIE NYE (LMT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:NYE
Last Name:REHKOPF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 LARCH CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41017-9447
Mailing Address - Country:US
Mailing Address - Phone:859-466-6909
Mailing Address - Fax:
Practice Address - Street 1:2538 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-466-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1839225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist