Provider Demographics
NPI:1649011925
Name:DOTSON, REBECCA JANE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:DOTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:VAUGHNSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45893-0023
Mailing Address - Country:US
Mailing Address - Phone:419-234-0116
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 23
Practice Address - Street 2:
Practice Address - City:VAUGHNSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45893-0023
Practice Address - Country:US
Practice Address - Phone:419-234-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide