Provider Demographics
NPI:1255108874
Name:REBMAN, SUSAN DIANE
Entity type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:DIANE
Last Name:REBMAN
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 1:33 AMBERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7060
Mailing Address - Country:US
Mailing Address - Phone:614-937-0882
Mailing Address - Fax:
Practice Address - Street 1:33 AMBERSIDE DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-7060
Practice Address - Country:US
Practice Address - Phone:614-937-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant