Provider Demographics
NPI:1851068522
Name:AMERICAN HORSE, REBEKAH MARIE
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:MARIE
Last Name:AMERICAN HORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0767
Mailing Address - Country:US
Mailing Address - Phone:402-878-2231
Mailing Address - Fax:
Practice Address - Street 1:225 S BLUFF ST
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-6807
Practice Address - Country:US
Practice Address - Phone:420-878-2231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL15104164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse