Individual
REBECCA IAZIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
91837 MARCOLA RD, SPRINGFIELD, OR 97478-9708
(541) 933-2556
Mailing address
91837 MARCOLA RD, SPRINGFIELD, OR 97478-9708
(541) 933-2556
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
141334
OR
163W00000X
Registered Nurse
Primary
092003098RN
OR
Other
Enumeration date
11/10/2013
Last updated
11/10/2013
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