Provider Demographics
NPI:1932244811
Name:DEWHURST, REBECCA R (RAGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:R
Last Name:DEWHURST
Suffix:
Gender:F
Credentials:RAGISTERED NURSE
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:ROSEBUD IHS HOSPITAL
Mailing Address - Street 2:SOLDIER CREEK ROAD
Mailing Address - City:ROSEBUD
Mailing Address - State:SD
Mailing Address - Zip Code:57570
Mailing Address - Country:US
Mailing Address - Phone:605-747-2231
Mailing Address - Fax:605-747-2216
Practice Address - Street 1:ROSEBUD IHS HOSPITAL
Practice Address - Street 2:SOLDIER CREEK ROAD
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570
Practice Address - Country:US
Practice Address - Phone:605-747-2231
Practice Address - Fax:605-747-2216
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDRO31981163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse