Individual
REBECCA BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 773-8252
Mailing address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 773-8252
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN184281
AZ
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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