Provider Demographics
NPI:1912212127
Name:HALCOMB, REBECCA ANNE (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:HALCOMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3582 EL REGO DR
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1654
Mailing Address - Country:US
Mailing Address - Phone:513-317-9440
Mailing Address - Fax:
Practice Address - Street 1:3582 EL REGO DR
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1654
Practice Address - Country:US
Practice Address - Phone:513-317-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH349622163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health