Individual
DR. REBEKAH ANN BLICKENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-3886
(317) 963-5492
Mailing address
1701 N SENATE BLVD RM AG012, INDIANAPOLIS, IN 46202-1239
(724) 766-0017
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075265A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201233400
—
IN
Enumeration date
05/19/2014
Last updated
12/01/2016
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