Provider Demographics
NPI:1922377795
Name:HAUSERMANN, REBECCA LEA (RN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEA
Last Name:HAUSERMANN
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 1:2007 WOODVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:OH
Mailing Address - Zip Code:45122-9281
Mailing Address - Country:US
Mailing Address - Phone:513-625-1326
Mailing Address - Fax:
Practice Address - Street 1:2007 WOODVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:OH
Practice Address - Zip Code:45122-9281
Practice Address - Country:US
Practice Address - Phone:513-625-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN246029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse