Provider Demographics
NPI:1245450220
Name:EUSEY, REBECCA ANNETTE
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANNETTE
Last Name:EUSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 WEST MAIN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904
Mailing Address - Country:US
Mailing Address - Phone:419-989-1694
Mailing Address - Fax:
Practice Address - Street 1:91 WEST MAIN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904
Practice Address - Country:US
Practice Address - Phone:419-989-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
2490960Medicare ID - Type Unspecified