Provider Demographics
NPI:1356357586
Name:PFABE, REBECCA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:PFABE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SOUTH 70TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4293
Mailing Address - Country:US
Mailing Address - Phone:402-488-1400
Mailing Address - Fax:402-488-3879
Practice Address - Street 1:1101 SOUTH 70TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4293
Practice Address - Country:US
Practice Address - Phone:402-488-1400
Practice Address - Fax:402-488-3879
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE90001636199Medicaid
NE500028747OtherRAILROAD MEDICARE
NE500028747OtherRAILROAD MEDICARE
NEP47556Medicare UPIN