Individual
JOHN GLENN REBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1612 S DORA ST, UKIAH, CA 95482-6519
(707) 367-0579
(707) 468-4313
Mailing address
1612 S DORA ST, UKIAH, CA 95482-6519
(707) 367-0579
(707) 468-4313
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
483766
CA
163WH0200X
Home Health Registered Nurse
483766
CA
163WI0500X
Infusion Therapy Registered Nurse
Primary
483766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
483766
NURSING LICENSE
CA
Enumeration date
03/15/2011
Last updated
03/15/2011
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