Provider Demographics
NPI:1255815965
Name:SAMBERG, REBECCA LEIGH (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LEIGH
Last Name:SAMBERG
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1119 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2905
Practice Address - Country:US
Practice Address - Phone:307-266-2772
Practice Address - Fax:307-266-2076
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY1801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty