Provider Demographics
NPI:1205476272
Name:OAKLEY, REBECCA RAE (FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RAE
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 S PALISADES DR
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-6694
Mailing Address - Country:US
Mailing Address - Phone:801-318-0525
Mailing Address - Fax:
Practice Address - Street 1:417 S PALISADES DR
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-6694
Practice Address - Country:US
Practice Address - Phone:801-368-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8709392-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily