Provider Demographics
NPI:1295053130
Name:BOATWRIGHT, REBECCA CATHERINE (RN)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CATHERINE
Last Name:BOATWRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:CATHERINE
Other - Last Name:WINFREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:95 CLARKSON ST
Mailing Address - Street 2:#9
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3793
Mailing Address - Country:US
Mailing Address - Phone:303-918-5126
Mailing Address - Fax:
Practice Address - Street 1:95 CLARKSON ST
Practice Address - Street 2:# 9
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3793
Practice Address - Country:US
Practice Address - Phone:303-918-5126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-15
Last Update Date:2010-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100587163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse