Provider Demographics
NPI:1679699730
Name:JEHN, REBECCA LYN (MPT,MHSA,OCS,FAAOMPT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYN
Last Name:JEHN
Suffix:
Gender:F
Credentials:MPT,MHSA,OCS,FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 RODEO DR
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1279
Mailing Address - Country:US
Mailing Address - Phone:513-354-3700
Mailing Address - Fax:513-354-3705
Practice Address - Street 1:600 RODEO DR
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1279
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-354-3705
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004916225100000X
OH008643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100220960Medicaid
K046440OtherMEDICARE PTAN