Provider Demographics
NPI:1255353736
Name:HARPER, REBECKA SUE (APNP)
Entity type:Individual
Prefix:
First Name:REBECKA
Middle Name:SUE
Last Name:HARPER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:REBECKA
Other - Middle Name:SUE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N46777 COUNTY ROAD V
Mailing Address - Street 2:
Mailing Address - City:ELEVA
Mailing Address - State:WI
Mailing Address - Zip Code:54738-8927
Mailing Address - Country:US
Mailing Address - Phone:715-287-4482
Mailing Address - Fax:
Practice Address - Street 1:6514 MEADOW RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6115
Practice Address - Country:US
Practice Address - Phone:715-530-0342
Practice Address - Fax:888-584-4944
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1963-033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily