Provider Demographics
NPI:1922137736
Name:GIANNAKOS, REBEKAH GOLDSTEIN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:GOLDSTEIN
Last Name:GIANNAKOS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR
Mailing Address - Street 2:CAMPUS DRIVE, BUILDING 140, ROOM 0106
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20742-0001
Mailing Address - Country:US
Mailing Address - Phone:301-314-8172
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR
Practice Address - Street 2:CAMPUS DRIVE, BUILDING 140, ROOM 0106
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-314-8172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR125869363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health