Provider Demographics
NPI:1871659532
Name:KAPPES, REBECCA M (WHCNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:KAPPES
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5201 HARRY HINES BLVD
Practice Address - Street 2:WISH TUBAL CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7708
Practice Address - Country:US
Practice Address - Phone:214-590-5306
Practice Address - Fax:214-590-2798
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253853363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041518402Medicaid
TX041518408Medicaid
TX041518411Medicaid
TX041518407Medicaid
TX041518409Medicaid
TX041518412Medicaid
TX041518406Medicaid
TX041518410Medicaid
TX041518403Medicaid
TX8Y5254OtherBLUE CROSS BLUE SHIELD
TX041518402Medicaid