Individual
REBECCA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3611 S REED RD STE 213, KOKOMO, IN 46902-3828
(765) 864-6767
(765) 864-6768
Mailing address
3611 S REED RD STE 213, KOKOMO, IN 46902-3828
(765) 864-6767
(765) 864-6768
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002298A
IN
Other
Enumeration date
05/16/2007
Last updated
11/12/2007
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