Individual
MRS. REBECCA RANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6501 N 19TH AVE, PHOENIX, AZ 85015-1646
(602) 795-6020
Mailing address
13523 BARRETT PARKWAY DRIVE, SUITE 104, BALLWIN, MO 63021-3802
(636) 938-6868
(636) 938-1486
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
130864
MO
367500000X
Certified Registered Nurse Anesthetist
209-002256
IL
367500000X
Certified Registered Nurse Anesthetist
209002256
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
290671
AZ
Other
Enumeration date
01/24/2008
Last updated
02/29/2024
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