Provider Demographics
NPI:1790873495
Name:O'DER, REBECCA B (CFNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:B
Last Name:O'DER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2989
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:
Practice Address - Street 1:7545 BEECHMONT AVE STE N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4231
Practice Address - Country:US
Practice Address - Phone:513-232-0011
Practice Address - Fax:513-232-8434
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily