Organization
PAVILION PEDIATRIC CENTER, LLC
Active
Other names
RECTOR PEDIATRICS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE RECTOR NP/OWNER (OWNER)
(765) 231-9494
Entity
Organization
Contact information
Practice address
3711 N. EVERBROOK LANE, MUNCIE, IN 47304-5270
(765) 231-9494
(765) 587-4456
Mailing address
3711 N. EVERBROOK LANE, MUNCIE, IN 47304-5270
(765) 231-9494
(765) 587-4456
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100362560
—
IN
05
—
201328850
—
IN
05
—
201337310A
—
IN
Enumeration date
12/10/2015
Last updated
03/06/2025
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