Provider Demographics
NPI:1639903610
Name:REBMAN, LAUREN TERESE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:TERESE
Last Name:REBMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S ALMA SCHOOL RD STE 11000
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-2086
Mailing Address - Country:US
Mailing Address - Phone:520-341-6542
Mailing Address - Fax:480-631-0546
Practice Address - Street 1:1201 S ALMA SCHOOL RD STE 11000
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-2086
Practice Address - Country:US
Practice Address - Phone:520-341-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ310497363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty