Individual
REBECKA ANN REATHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
(719) 557-5097
Mailing address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5855
(719) 557-5097
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0994158
CO
363LA2100X
Acute Care Nurse Practitioner
Primary
APN.0994158-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000182390
—
CO
Enumeration date
09/20/2018
Last updated
03/01/2023
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