Provider Demographics
NPI:1790767713
Name:WESTER, REBECCA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARY
Last Name:WESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31266
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-0266
Mailing Address - Country:US
Mailing Address - Phone:402-249-6136
Mailing Address - Fax:402-835-5212
Practice Address - Street 1:4908 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2913
Practice Address - Country:US
Practice Address - Phone:402-249-6136
Practice Address - Fax:402-835-5212
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5952207QA0505X, 207R00000X
NE21178207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170111201Medicaid
NE10026724400Medicaid
NE47072557525Medicaid
IA1790767713Medicaid
TXI09609Medicare UPIN
NE47072557525Medicaid
NE281534Medicare PIN