Provider Demographics
NPI:1801022454
Name:RABE, BECKY JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:JEAN
Last Name:RABE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:BECKY
Other - Middle Name:JEAN
Other - Last Name:COPELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1700 MALL DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-3849
Mailing Address - Country:US
Mailing Address - Phone:218-727-0990
Mailing Address - Fax:218-491-7050
Practice Address - Street 1:1700 MALL DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-3849
Practice Address - Country:US
Practice Address - Phone:218-727-0990
Practice Address - Fax:218-491-7050
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR140968-4163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse