Individual
MS. REBECCA LA DINE EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSRN
Contact information
Practice address
146 GETTLE ROAD, ST. 1, AVERILL PARK, NY 12018
(518) 674-7020
(518) 674-7052
Mailing address
146 GETTLE ROAD, ST. 1, AVERILL PARK, NY 12018
(518) 674-7050
(518) 674-3802
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
411152-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1379024
—
NY
Enumeration date
01/05/2012
Last updated
01/05/2012
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