Provider Demographics
NPI:1821723669
Name:KNOTTS, REBECCA SINDY (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SINDY
Last Name:KNOTTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3819
Mailing Address - Country:US
Mailing Address - Phone:440-453-0189
Mailing Address - Fax:
Practice Address - Street 1:823 W 18TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3819
Practice Address - Country:US
Practice Address - Phone:440-453-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN417574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse