Provider Demographics
NPI:1205301835
Name:REBECCA L. STOECKLER, LLC
Entity type:Organization
Organization Name:REBECCA L. STOECKLER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:907-247-8783
Mailing Address - Street 1:3528 TONGASS AVE
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5635
Mailing Address - Country:US
Mailing Address - Phone:907-247-8783
Mailing Address - Fax:
Practice Address - Street 1:3528 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5635
Practice Address - Country:US
Practice Address - Phone:907-247-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care