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Individual

MRS. REBEKAH L EASTON-HOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
210 N BROADWAY ST STE 1, BEREA, KY 40403-2212
(859) 756-3630
Mailing address
210 N BROADWAY ST STE 1, BEREA, KY 40403-2212
(859) 756-3630

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3005774
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3005774
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
109518
SIHO NORTON ICC
KY
01
1105722
RN LICENSE
KY
01
5774P
ARNP
KY
Enumeration date
10/06/2008
Last updated
12/23/2021
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