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Individual
REBECCA KATHRYN PRIVON
Active
Individual
REBECCA KATHRYN PRIVON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R895251
MS
363L00000X
Nurse Practitioner
R895251
MS
390200000X
Student in an Organized Health Care Education/Training Program
R895251
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08388778
—
MS
01
—
P01361202
RAILROAD MEDICARE
MS
Enumeration date
05/13/2014
Last updated
08/04/2016
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