Provider Demographics
NPI:1689310468
Name:BARE, REBECCA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BARE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:HOME HEALTH
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701
Mailing Address - Country:US
Mailing Address - Phone:304-526-2075
Mailing Address - Fax:304-526-2006
Practice Address - Street 1:1340 HAL GREER BLVD
Practice Address - Street 2:HOME HEALTH DEPARTMENT
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2570
Practice Address - Country:US
Practice Address - Phone:304-526-2075
Practice Address - Fax:304-526-2006
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49250163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health