Provider Demographics
NPI:1982061024
Name:PRICE, REBEKAH DIANN (NP)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:DIANN
Last Name:PRICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 ARAPAHOE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1044
Mailing Address - Country:US
Mailing Address - Phone:727-266-3678
Mailing Address - Fax:
Practice Address - Street 1:3300 ARAPAHOE AVE STE 204
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1044
Practice Address - Country:US
Practice Address - Phone:727-266-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993641363LF0000X, 363LF0000X
CO0103086363LF0000X
SC1979-2A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1982061024Medicaid
NC1982061024Medicaid