Provider Demographics
NPI:1851948863
Name:RUBESICH, REBEKAH HOPE (CNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:HOPE
Last Name:RUBESICH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 NEWARK GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-1436
Mailing Address - Country:US
Mailing Address - Phone:740-815-0239
Mailing Address - Fax:
Practice Address - Street 1:594 NEWARK GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1436
Practice Address - Country:US
Practice Address - Phone:740-618-2322
Practice Address - Fax:740-618-2324
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH352789163WP0808X
OH0027689363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health