Individual
REBECCA ANNE LEGRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
507 N 17TH STREET, MILWAUKEE, WI 53233
(414) 288-0607
Mailing address
PO BOX 2901, PAYSON, AZ 85547-2901
(928) 978-6588
(928) 468-9280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8657
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2021
Last updated
02/14/2022
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