Individual
MRS. REBECCA MASSART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2605-033
WI
363LW0102X
Women's Health Nurse Practitioner
2605-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36033600
—
WI
Enumeration date
12/11/2006
Last updated
10/07/2025
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