Provider Demographics
NPI:1750768503
Name:MARKLE, REBECCA ANNE (CRNA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:MARKLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:RM A504
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1716
Mailing Address - Country:US
Mailing Address - Phone:909-558-7811
Mailing Address - Fax:909-558-0180
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:RM A504
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1716
Practice Address - Country:US
Practice Address - Phone:909-558-7811
Practice Address - Fax:909-558-0180
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95000319367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered