Provider Demographics
NPI:1992178826
Name:KERBY, REBECCA (ARNP, FNP-C, IBCLC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KERBY
Suffix:
Gender:F
Credentials:ARNP, FNP-C, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 135TH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9671
Mailing Address - Country:US
Mailing Address - Phone:563-549-8251
Mailing Address - Fax:
Practice Address - Street 1:1609 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-3426
Practice Address - Country:US
Practice Address - Phone:563-263-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAL-85679174N00000X
IAA173265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No174N00000XOther Service ProvidersLactation Consultant, Non-RN