Provider Demographics
NPI:1952452252
Name:SENKBEIL, REBECCA CRAMTON (RD,LD,CDE)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CRAMTON
Last Name:SENKBEIL
Suffix:
Gender:F
Credentials:RD,LD,CDE
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 2048
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2048
Mailing Address - Country:US
Mailing Address - Phone:251-432-4117
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:1303 DR MARTIN L KING JR AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603-5341
Practice Address - Country:US
Practice Address - Phone:251-432-4117
Practice Address - Fax:251-436-7765
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1156133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
051557542SENMedicare ID - Type Unspecified
Q69071Medicare UPIN